Individual provider Active NPI

Melody Yi Shi

  • Pediatric Endocrinology Physician
  • Fairfax, VA
National Provider Identifier
1831584150
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
0101272916 Issued in VA
Practice address
3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241
Phone
(703) 876-2788
Fax
(703) 839-8762
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101272916 VA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 0101272916 VA Primary

Addresses

Primary practice location

3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241

Mailing address

3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241
Phone (703) 876-2788

Other practice location 1

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221129001936 DC Practitioner - Pediatric Medicine 5597133389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Maryland School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S HospitalGroup PAC ID 0244143170, 212 clinicians

Practice addresses (Care Compare)

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (301) 572-3514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101272916VAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatrics CurrentSince Nov 11, 2022 Accepting new patients
Children'S Hospital Current Accepting new patients
Children'S Hospital CurrentSince Nov 11, 2022 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3023 Hamaker Ct
Ste 600
Fairfax, VA 22031
Phone (703) 839-8733

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1831584150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312241",
            "telephone_number": "703-876-2788",
            "fax_number": "703-839-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312241",
            "telephone_number": "703-876-2788",
            "fax_number": "703-839-8762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHI",
        "first_name": "MELODY",
        "middle_name": "YI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101272916",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "VA",
            "license": "0101272916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.