Individual provider Active NPI

Melanie Ann Crites-Bachert, D.O.

  • Urology Physician
  • Gresham, OR
National Provider Identifier
1487847554
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DO154071 Issued in OR
Practice address
24076 SE Stark St
Suite 310
Gresham, OR 97030-3373
Phone
(503) 492-6510
Fax
(503) 492-6502
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X DO154071 OR Primary

Addresses

Primary practice location

24076 SE Stark St
Suite 310
Gresham, OR 97030-3373

Mailing address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 263-4722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220726001376 AZ Practitioner - Urology 1355487877 Reassigns benefits to 1 organization
I20260514002510 WV Practitioner - Urology 1355487877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
West Virginia School of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

705 Garfield Ave
Suite 400
Parkersburg, WV 26101-5444
Phone (304) 865-5155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
77.5
Promoting interoperability
98
Improvement activities
40
Cost
74.58

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO154071ORMDUrology Physician
009379AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Hospital Current Accepting new patients
Ohio Specialty Physicians Corporation CurrentSince Jul 17, 2023 Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients
Ohio Specialty Physicians Corporation CurrentSince Jul 17, 2023 Accepting new patients
Kingman Healthcare, Inc CurrentSince Sep 1, 2022 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

1712 Sycamore Ave
Kingman, AZ 86409
Phone (928) 681-8570

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2600 Tuscarawas St W
Ste 400
Canton, OH 44708
Phone (330) 458-2000

2600 Tuscarawas St W
Ste 520
Canton, OH 44708
Phone (330) 454-0702

Interoperability endpoints

  • Direct secure messaging: melanie.crites-bachert@direct.aultman.org

Organizations & group practices 7

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 1

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1487847554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-492-6510",
            "fax_number": "503-492-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITES-BACHERT",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "DO154071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.