Individual provider Active NPI

Daryl R Melvin, MD

  • Cardiovascular Disease Physician
  • Lansing, MI
National Provider Identifier
1891793675
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301039522 Issued in MI
Practice address
1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806
Phone
(517) 364-9650
Fax
(517) 364-9605
NPI assigned
Jul 14, 2005
Last updated
Sep 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301039522 MI Primary

Addresses

Primary practice location

1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 364-9650

Other identifiers 1

IdentifierTypeStateIssuer
1817454MedicaidMI

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000557 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Nuclear Medicine 0547172264 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association Cardiovascular Disease CurrentSince Jun 1, 2018 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1140 E Michigan Ave
Ste 40
Lansing, MI 48912
Phone (517) 483-7550

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1891793675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-9650",
            "fax_number": "517-364-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 400",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-9650",
            "fax_number": "517-364-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "DARYL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301039522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1817454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.