Individual provider Active NPI

Kraig A. Melville

  • Emergency Medical Services (Emergency Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1821043266
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
D0050708 Issued in MD
Practice address
900 S Caton Ave
Baltimore, MD 21229-5201
Phone
(410) 368-2014
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101284263 VA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X D0050708 MD Primary

Addresses

Primary practice location

900 S Caton Ave
Baltimore, MD 21229-5201

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

12997 Warwick Blvd
Newport News, VA 23602-8352
Phone (757) 369-9446

Other identifiers 1

IdentifierTypeStateIssuer
543213800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130507000292 DC Practitioner - Emergency Medicine 7911917059 Reassigns benefits to 1 organization
I20250710002275 VA Practitioner - Emergency Medicine 7911917059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michumi PLLCGroup PAC ID 5193784395, 40 clinicians

Practice addresses (Care Compare)

12997 Warwick Blvd
Newport News, VA 23602-8352
Phone (757) 369-9446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101284263VAMDEmergency Medicine Physician
D0050708MDMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Emergency Medicine Physicians, LLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
Michumi PLLC Emergency Medicine CurrentSince Jun 26, 2025 Accepting new patients
Memn Hospitalists, LLC Emergency Medicine Past Accepting new patients
Maryland Provo-I Medical Services, PC Emergency Medicine Past Accepting new patients
Peninsula Radiological Associates Limited PastSince Jun 26, 2025 Accepting new patients
Hospital Physician Services, LLLP Past Accepting new patients
Joseph S. Fastow, M.D., P.a. Past Accepting new patients

Locations

15001 Health Center Dr
Bowie, MD 20716
Phone (301) 262-5511

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

7300 Van Dusen Rd
Laurel, MD 20707
Phone (301) 725-4300

6567 George Washington Memorial Hwy
Gloucester, VA 23061
Phone (804) 824-9962

3321 W Mercury Blvd
Hampton, VA 23666
Phone (757) 224-0056

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

12997 Warwick Blvd
Newport News, VA 23602
Phone (757) 369-3357

120 Monticello Ave
Williamsburg, VA 23185
Phone (757) 564-3627

4740 George Washington Mem Hwy
Ste A
Yorktown, VA 23692
Phone (757) 890-6339

Organizations & group practices 8

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1821043266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "410-368-2014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12997 Warwick Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236028352",
            "country_code": "US",
            "telephone_number": "757-369-9446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "KRAIG",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101284263",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MD",
            "license": "D0050708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543213800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.