Individual provider Active NPI

Melinda Millan Dy, D.O.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1508870312
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02002334A Issued in IN
Practice address
2301 N Bendix Dr
Suite 500
South Bend, IN 46628-3486
Phone
(574) 647-1675
NPI assigned
Jul 28, 2006
Last updated
Sep 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02002334A IN Primary

Addresses

Primary practice location

2301 N Bendix Dr
Suite 500
South Bend, IN 46628-3486

Mailing address

3355 Douglas Rd
Suite 300
South Bend, IN 46635-1781

Other identifiers 1

IdentifierTypeStateIssuer
200833810MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110603000397 NV Practitioner - Family Practice 0648372466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

149 N Gibson Rd
Suite H
Henderson, NV 89014-6763
Phone (702) 558-6275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02002334AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Apr 16, 2011 Accepting new patients
Beacon Occupational Health, LLC Past Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

149 N Gibson Rd
Ste H
Henderson, NV 89014
Phone (702) 558-6275

151 W Brooks Ave
North Las Vegas, NV 89030
Phone (702) 399-6545

255 Glendale Ave
Ste 12
Sparks, NV 89431
Phone (775) 356-8181

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1508870312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "address_2": "SUITE 300",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N BENDIX DR",
            "address_2": "SUITE 500",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283486",
            "telephone_number": "574-647-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DY",
        "first_name": "MELINDA",
        "middle_name": "MILLAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002334A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200833810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.