Lissa M Melvin, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

M6738 Issued in TX

Practice address

5414 Fredericksburg Rd
Suite 200
San Antonio, TX 78229

Phone

(210) 614-2209

Fax

(210) 614-5714

NPI assigned

Nov 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Lissa K Magloire Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

University of Virginia School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baylor College of MedicineGroup PAC ID 0648405738, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmelvin209676@christushealth.direct-ci.net

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.

• Baylor College of Medicine

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Christus Santa Rosa Health Care Corporation

  • General Acute Care Hospital
  • New Braunfels, TX
  • NPI 1114725033
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1881677979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 FREDERICKSBURG RD",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-2209",
            "fax_number": "210-614-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 FREDERICKSBURG RD",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-2209",
            "fax_number": "210-614-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "LISSA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "042041",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "M6738",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "M6738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1867277-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001420413",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISSA",
            "last_name": "MAGLOIRE",
            "middle_name": "K",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Peter Michael Melton, LMT, MMT
• Stephanie Melton
• Evan F. Meltzer, DPM
• Melvin L Shanley DDS PA
• Melvin L. Cohen, M.D.
• Raul Membreno, MD, MPH
• Stanley James Memmott
• Rafian Rehan Memon
• Memorial Urology Associates, PA
• Memory & Wellness Senior Center

• Maternal & Fetal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.