Individual provider Active NPI

Melissa T Hendrickson, PA

  • Physician Assistant
  • Marquette, MI
National Provider Identifier
1972823110
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003620 Issued in MI
Practice address
580 W College Ave
Marquette, MI 49855-2705
Phone
(906) 225-7808
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003620 MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2705

Mailing address

2837 US 41 W
Marquette, MI 49855-2252
Phone (906) 225-3964

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050107000050 MI Practitioner - Physician Assistant 5092763987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-2675

850 W Baraga Ave
Marquette, MI 49855-4550

Hospital & facility affiliations

  • Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003620MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc Physician Assistant CurrentSince Jan 2, 2018 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jan 2, 2018 Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients

Locations

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

850 W Baraga Ave
Ste 31
Marquette, MI 49855
Phone (906) 449-3600

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

Interoperability endpoints

  • Direct secure messaging: melissa.hendrickson.1@8233.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1972823110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "MELISSA",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.