Individual provider Active NPI

Melissa Demasi, NP

  • Pediatric Nurse Practitioner
  • Irving, TX
National Provider Identifier
1619981784
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP113773 Issued in TX
Practice address
3501 N Macarthur Blvd Ste 360
Irving, TX 75062-3621
Phone
(972) 256-3700
Fax
(866) 630-6348
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 635842 TX
Pediatric Nurse Practitioner 363LP0200X AP113773 TX Primary

Addresses

Primary practice location

3501 N Macarthur Blvd Ste 360
Irving, TX 75062-3621

Mailing address

3501 N Macarthur Blvd Ste 500
Irving, TX 75062-3675
Phone (972) 256-3700

Other identifiers 1

IdentifierTypeStateIssuer
635842OtherTXNURSE PRACTITIONERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050831000412 TX Practitioner - Nurse Practitioner 2961434881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
635842TXMDNurse Practitioner
AP113773TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Nurse Practitioner Past Accepting new patients

Locations

1935 Medical District Dr
Unit A
Dallas, TX 75235

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1619981784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD STE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623675",
            "telephone_number": "972-256-3700",
            "fax_number": "866-630-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD STE 360",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623621",
            "telephone_number": "972-256-3700",
            "fax_number": "866-630-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASI",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "635842",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP113773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONERS",
            "identifier": "635842",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.