Individual provider Active NPI

Melissa Lynn Trachtenberg, PA-C

  • Medical Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1972656312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101170 Issued in FL
Practice address
1800 E Commercial Blvd
Fort Lauderdale, FL 33308-3725
Phone
(954) 491-2444
Fax
(954) 491-8818
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101170 FL Primary

Addresses

Primary practice location

1800 E Commercial Blvd
Fort Lauderdale, FL 33308-3725

Mailing address

1800 E Commercial Blvd
Fort Lauderdale, FL 33308-3725
Phone (954) 491-2444

Other identifiers 1

IdentifierTypeStateIssuer
3713OtherFLPRESCRIBING PA-C NUMBER

Other names 1

  • Mrs. Melissa Lynn Cooper-Trachtenberg Former name

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
I20070709000290 FL Practitioner - Physician Assistant 8022118884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
61.92
Improvement activities
40
Cost
64.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9101170FLMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mtrachtenberg@cas.directglo.com

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972656312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083725",
            "telephone_number": "954-491-2444",
            "fax_number": "954-491-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083725",
            "telephone_number": "954-491-2444",
            "fax_number": "954-491-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACHTENBERG",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIBING PA-C NUMBER",
            "identifier": "3713",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "COOPER-TRACHTENBERG",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.