Individual provider Active NPI

Melissa Mariutza, NP

  • Primary Care Nurse Practitioner
  • Brockway, MI
National Provider Identifier
1457607251
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704220563 Issued in MI
Practice address
7470 Brockway Rd
Brockway, MI 48097-3458
Phone
(810) 387-3211
NPI assigned
Jul 30, 2012
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704220563 MI
Primary Care Nurse Practitioner 363LP2300X 4704220563 MI Primary

Addresses

Primary practice location

7470 Brockway Rd
Brockway, MI 48097-3458

Mailing address

7470 Brockway Rd
Brockway, MI 48097-3458
Phone (810) 387-3211

Other names 1

  • Melissa Hinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130311000497 MI Practitioner - Nurse Practitioner 9830344233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704220563MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Sep 1, 2023 Accepting new patients
Vpa PC CurrentSince Sep 1, 2023 Accepting new patients
Vpa PC Current Accepting new patients

Locations

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1457607251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7470 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973458",
            "telephone_number": "810-387-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7470 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973458",
            "telephone_number": "810-387-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIUTZA",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704220563",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704220563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HINSON",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brockway, MI

Sources for this page

Verify at the official NPI Registry.