Individual provider Active NPI

Melvin Nelson Levers III, PA-C

  • Surgical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1851763361
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-06040 Issued in NC
Practice address
2010 Baldwin LN
Winston Salem, NC 27103-5846
Phone
(336) 277-1717
NPI assigned
Oct 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-06040 NC Primary

Addresses

Primary practice location

2010 Baldwin LN
Winston Salem, NC 27103-5846

Mailing address

2010 Baldwin LN
Winston Salem, NC 27103-5846

Other identifiers 1

IdentifierTypeStateIssuer
0010-06040OtherNCNC STATE MEDICAL BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlevers286658@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151231000995 NC Practitioner - Physician Assistant 1850693276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

140 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 716-4131

3903 N Elm St
Greensboro, NC 27455-2594
Phone (336) 713-4944

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-06040NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 5, 2024 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: mlevers2900450@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1851763361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BALDWIN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BALDWIN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035846",
            "telephone_number": "336-277-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERS",
        "first_name": "MELVIN",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-06040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE MEDICAL BOARD",
            "identifier": "0010-06040",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlevers286658@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2010 Baldwin Ln",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271035846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.