Melissa A Prasatik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60388636 Issued in WA

Practice address

10117 NE 58TH St Ste 200
Kirkland, WA 98033-7450

Phone

(425) 821-6363

Fax

(425) 821-4804

NPI assigned

Apr 23, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Dermatology ,PLLCGroup PAC ID 9032492822, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Legacy Dermatology, PLLC

  • Dermatology Physician
  • Frisco, TX
  • NPI 1134588148
  Medicare reassignment Care Compare group NPD
• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment
• North Pacific Dermatology Services, LLC

  • Dermatology Physician
  • Renton, WA
  • NPI 1790973436
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467670794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD",
            "address_2": "STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650",
            "fax_number": "214-736-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 NE 58TH ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337450",
            "telephone_number": "425-821-6363",
            "fax_number": "425-821-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASATIK",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60388636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W Mark Potampa, M.D.
• Daniela Potra
• Amanda Claire Potter, MA
• Kaja Powers, CPM, LM
• Praesto Community Fund
• Kathleen Preciado-Partida, MD
• Ramya Premchand, PT
• Kimberly Premetz
• Premise Health of Washington Medical PC (Google Health and Wellness Center Kirkland Urban)
• Premise Health of Washington Medical, P.C (Google Wellness Center)

• Physician Assistant in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.