NPIMap

Individual provider Active NPI

Melisha Bissram, MD

  • Nephrology Physician
  • Newport News, VA
National Provider Identifier
1942417183
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101243205 Issued in VA
Practice address
739 Thimble Shoals Blvd
Suite 801
Newport News, VA 23606-3562
Phone
(757) 873-1009
Fax
(757) 873-7689
NPI assigned
May 17, 2007
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101243205 VA
Nephrology Physician 207RN0300X 0101243205 VA Primary

Addresses

Primary practice location

739 Thimble Shoals Blvd
Suite 801
Newport News, VA 23606-3562

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318

Other identifiers 1

IdentifierTypeStateIssuer
1942417183MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080722000767 VA Practitioner - NephrologyPractitioner - Internal Medicine 9133292642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

739 Thimble Shoals Blvd
Suite 801
Newport News, VA 23606-3585
Phone (757) 873-1009

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243205VAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Mar 1, 2010 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. Internal Medicine CurrentSince Mar 1, 2010 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients
Lynchburg Nephrology Physicians PLLC Past Accepting new patients

Locations

739 Thimble Shoals Blvd
Ste 801
Newport News, VA 23606
Phone (757) 873-1009

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

Interoperability endpoints

  • Direct secure messaging: mbissram12050@direct.rivhs.com

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

Hospital & facility affiliations 6

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1942417183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 801",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063562",
            "telephone_number": "757-873-1009",
            "fax_number": "757-873-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSRAM",
        "first_name": "MELISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243205",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101243205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942417183",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.