Individual provider Active NPI

Melissa Ann Miller, PA-C

  • Physician Assistant
  • Bel Air, MD
National Provider Identifier
1972937472
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C05113 Issued in MD
Practice address
1505 E. Churchville Road.
Bel Air, MD 21015
Phone
(410) 420-6970
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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 C05113 MD Primary

Addresses

Primary practice location

1505 E. Churchville Road.
Bel Air, MD 21015

Mailing address

1513 Blakes Legacy Dr
Bel Air, MD 21014-1946
Phone (410) 652-3658

Other names 1

  • Melissa Ann Cocco Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160428001461 MD Practitioner - Physician Assistant 3274832043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1505 E Churchville Rd
Bel Air, MD 21014-4742

2006 Rock Spring Rd
Forest Hill, MD 21050-2607
Phone (410) 569-0044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C05113MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Mar 19, 2016 Accepting new patients
MNR Industries LLC CurrentSince Mar 19, 2016 Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

7701 Harford Rd
Parkville, MD 21234
Phone (443) 438-5147

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.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1972937472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 BLAKES LEGACY DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210141946",
            "telephone_number": "410-652-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E. CHURCHVILLE ROAD.",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21015",
            "telephone_number": "410-420-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "COCCO",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.