NPIMap

Individual provider Active NPI

Melanie Ethell Mirande, MD

  • Family Medicine Physician
  • Canton, OH
National Provider Identifier
1437123783
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35072373 Issued in OH
Practice address
6525 Market Ave N
Suite 101
Canton, OH 44721-2430
Phone
(330) 494-9785
Fax
(330) 494-9798
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35072373 OH Primary

Addresses

Primary practice location

6525 Market Ave N
Suite 101
Canton, OH 44721-2430

Mailing address

6525 Market Ave N
Suite 101
Canton, OH 44721-2430
Phone (330) 494-9785

Other identifiers 1

IdentifierTypeStateIssuer
2871218MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000396 OH Practitioner - Family Practice 5890881718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Community Health CenterGroup PAC ID 3971884636, 27 clinicians
Family Medicine IncGroup PAC ID 9335235258, 2 clinicians

Practice addresses (Care Compare)

2600 7TH St SW
Canton, OH 44710-1709
Phone (330) 363-6242

6525 Market Ave N
Suite 101
Canton, OH 44721-4400
Phone (330) 494-9784

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35072373OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Inc Family Medicine CurrentSince Jul 9, 2007 Accepting new patients
My Community Health Center Family Medicine CurrentSince Jan 5, 2018 Accepting new patients
My Community Health Center Family Medicine CurrentSince Jan 5, 2018 Accepting new patients

Locations

2600 7th St SW
Canton, OH 44710
Phone (330) 363-6242

6525 Market Ave N
Ste 101
North Canton, OH 44721
Phone (330) 494-9784

Interoperability endpoints

  • Direct secure messaging: drmirande@fmi.medentdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1437123783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 MARKET AVE N",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212430",
            "telephone_number": "330-494-9785",
            "fax_number": "330-494-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 MARKET AVE N",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212430",
            "telephone_number": "330-494-9785",
            "fax_number": "330-494-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDE",
        "first_name": "MELANIE",
        "middle_name": "ETHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35072373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871218",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.