NPIMap

Individual provider Active NPI

Melisa Ann Ardis, PA-C

  • Family Medicine Physician
  • Mt Pleasant, MI
National Provider Identifier
1619517620
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5601009834APP20 Issued in MI
Practice address
2480 Rosewood N
Mt Pleasant, MI 48858
Phone
(989) 775-3823
Fax
(989) 773-5061
NPI assigned
Jan 8, 2020
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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 5601009834APP20 MI Primary

Addresses

Primary practice location

2480 Rosewood N
Mt Pleasant, MI 48858

Mailing address

2480 Rosewood Dr.
Mount Pleasant, MI 48858
Phone (989) 775-3823

Other practice location 1

302 Hobart St
Cadillac, MI 49601-2379
Phone (231) 876-2644

Other names 1

  • Melisa Ann Bazuin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200221000374 MI Practitioner - Physician Assistant 9234566894 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare CadillacGroup PAC ID 6305161514, 104 clinicians

Practice addresses (Care Compare)

217 S Madison St
Traverse City, MI 49684-2321
Phone (231) 392-8400

302 Hobart St
Cadillac, MI 49601-2379
Phone (231) 876-2644

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601009834APP20MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Cadillac Family Medicine CurrentSince Mar 29, 2023 Accepting new patients
Munson Healthcare Cadillac CurrentSince Mar 29, 2023 Accepting new patients
Munson Healthcare Cadillac Past Accepting new patients

Locations

302 Hobart St
Cadillac, MI 49601
Phone (231) 775-8814

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1619517620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 ROSEWOOD DR.",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-775-3823",
            "fax_number": "810-275-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 ROSEWOOD N",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-775-3823",
            "fax_number": "989-773-5061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012379",
            "country_code": "US",
            "telephone_number": "231-876-2644",
            "fax_number": "231-876-5106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARDIS",
        "first_name": "MELISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601009834APP20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISA",
            "last_name": "BAZUIN",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.