Individual provider Active NPI

Melissa Mae Pietras, PA-C

  • Physician Assistant
  • Fort Belvoir, VA
National Provider Identifier
1669601282
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005352 Issued in MI
Practice address
Fort Belvoir Community Hospital
9300 Dewitt Loop
Fort Belvoir, VA 22060
Phone
(571) 231-3224
NPI assigned
Jul 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0005879 MD
Physician Assistant 363A00000X 5601005352 MI Primary

Addresses

Primary practice location

Fort Belvoir Community Hospital
9300 Dewitt Loop
Fort Belvoir, VA 22060

Mailing address

3109 Waterside LN
Alexandria, VA 22309-2131
Phone (616) 826-1886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3539COMDPsychologist
C0005879MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cardiothoracic Surgeons PLC PastSince Jan 1, 1995 Accepting new patients
Hastings Emergency Physicians PLC Medical Past Accepting new patients
Spectrum Health Primary Care Partners Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1669601282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 WATERSIDE LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223092131",
            "telephone_number": "616-826-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORT BELVOIR COMMUNITY HOSPITAL",
            "address_2": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "22060",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRAS",
        "first_name": "MELISSA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005879",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.