Individual provider Active NPI

Melissa Rae Pelosi, PA

  • Medical Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1881148419
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
9035 Pines Blvd
Pembroke Pines, FL 33024
Phone
(954) 378-0333
NPI assigned
Aug 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109769 FL
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

9035 Pines Blvd
Pembroke Pines, FL 33024

Mailing address

215 SE 8TH Ave Apt 680
Fort Lauderdale, FL 33301-3885
Phone (561) 251-7610

Other identifiers 1

IdentifierTypeStateIssuer
1881148419OtherFLNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Melissa.pelosi@carespot.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170724002977 FL Practitioner - Physician Assistant 1153691100 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic/South Florida LLCGroup PAC ID 5496762171, 27 clinicians

Practice addresses (Care Compare)

1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone (954) 580-4001

9035 Pines Blvd
Pembroke Pines, FL 33024-6440
Phone (954) 378-0333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109769FLMDPhysician Assistant

Organizations & group practices 5

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": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1881148419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE 8TH AVE APT 680",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013885",
            "telephone_number": "561-251-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-378-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOSI",
        "first_name": "MELISSA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109769",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881148419",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Melissa.pelosi@carespot.com",
            "affiliation": "N",
            "address_1": "9035 Pines Blvd",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.