Melissa Diane Loo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8405 Issued in AZ

Practice address

14044 W Camelback Rd Ste 204
Litchfield Park, AZ 85340-9426

Phone

(623) 935-9600

Fax

(623) 935-9602

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, KS, TN3 enrollments

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 3

Specialty

Physician Assistant

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 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 and National Provider Directory roles.

• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Circle Medical Care Group PA

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1972358760

  AZ

  Medicare reassignment NPD
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1922532944
  Medicare reassignment
• Pinnacle Family Medicine PLC

  • Family Medicine Physician
  • Litchfield Park, AZ
  • NPI 1639208325
  Medicare reassignment
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Columbia, MD
  • NPI 1811765449
  NPD
• Pinnacle Family Medicine PLC

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1093590341
  NPD (past)
• South Carolina Center for Intergrative Medicine

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1669981429
  NPD (past)

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1477019784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 204",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409426",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 204",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409426",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9105",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3258",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Well Assisted Living LLC
• Roger Dayton Livingood, DDS
• Marilyn Lobo, DDS
• Amanda Kimberley Logid, LMFT
• Talya Shvonne Long
• Roxanne Diane Lopez, LMT
• Sofia Lopez, RBT
• Donna Lowe, CNIM
• Melody Lowery
• Serena Loyola

• Physician Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.