Active NPI
Melissa Pavelack Golden, DO
- Pediatric Critical Care Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1558892265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 5101028320
- Practice address
- 100 Michigan St NE
Grand Rapids, MI 49503-2560 - Phone
- (616) 267-1526
- NPI assigned
- Mar 23, 2017
- Last updated
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 5101028320 | MI | Primary |
Addresses
Primary practice location
100 Michigan St NE
Grand Rapids, MI 49503-2560
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Other names 1
- Melissa Pavelack
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgolden2838424@epic00.corewelldirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/ |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennedy Krieger Associates | Pediatrics | Current | Accepting new patients |
| Kennedy Krieger Associates | Pediatrics | Current | Accepting new patients |
| Spectrum Health Hospitals | Past | Accepting new patients |
Locations
1741 Ashland Ave
Fl 6
Baltimore, MD 21205
Phone (443) 923-1839
707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870
Interoperability endpoints
- mgolden2838424@epic00.corewelldirect.org
- mpavelack39014@direct.kennedykrieger.org
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.
-
- Pediatrics Physician
- Baltimore, MD
- NPI 1871515783
-
- Pediatrics Physician
- Middle River, MD
- NPI 1841009842
-
dba Corewell Health Grand Rapids Hospital
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1558892265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE # MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-267-1526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEN",
"first_name": "MELISSA",
"middle_name": "PAVELACK",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MI",
"license": "5101028320",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mgolden2838424@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "100 Michigan St NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "100 Michigan St NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "PAVELACK",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.