Melanie Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010239 Issued in MI

Practice address

41100 Plymouth Rd Ste 110
Plymouth, MI 48170-3895

Phone

(734) 715-1907

Fax

(734) 715-1908

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Victor M. Cruz MD, P.C.Group PAC ID 3375604952, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Victor M. Cruz MD, P.C.

  • Psychiatry Physician
  • Livonia, MI
  • NPI 1023036514
  Medicare reassignment Care Compare group
• Momentum Mental Health PLLC

  • Psychiatry Physician
  • Plymouth, MI
  • NPI 1609727882

  Single Specialty

  NPD Authorized official
• Robert Garcia MD PC

  • Psychiatry Physician
  • Northville, MI
  • NPI 1760659312

  Single Specialty

  NPD

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1861024606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41100 PLYMOUTH RD STE B1-162",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703799",
            "telephone_number": "734-715-1907",
            "fax_number": "734-715-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41100 PLYMOUTH RD STE 110",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703895",
            "telephone_number": "734-715-1907",
            "fax_number": "734-715-1908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 E Oakley Park Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Commerce Township",
            "state": "MI",
            "postal_code": "483904318",
            "country_code": "US",
            "telephone_number": "734-715-1907",
            "fax_number": "734-715-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Montroy
• Moore Performance Health Services LLC
• Alayna Moore
• China Moore
• Jaymin Alexander Moore
• Rebeca Moore
• Shantanique Moore
• Tierra Moore
• Sarah Grace Moores
• Collin Moos

• Physician Assistant in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.