Individual provider Active NPI

Melissa Anne Wieciech, PA-C

  • Medical Physician Assistant
  • Columbia, MD
National Provider Identifier
1497067672
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004244 Issued in MD
Practice address
5755 Cedar LN
Columbia, MD 21044
Phone
(410) 740-7777
NPI assigned
Jul 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0004244 MD Primary

Addresses

Primary practice location

5755 Cedar LN
Columbia, MD 21044

Mailing address

5755 Cedar LN
Columbia, MD 21044-2999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20161123001375 MD Practitioner - Physician Assistant 8820234206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004244MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Feb 1, 2022 Accepting new patients
Johns Hopkins University CurrentSince Feb 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: mwieciech366003@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1497067672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-740-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECIECH",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.