Look up the most recent NPI and PECOS records

Melissa Elizabeth Stanczak

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

757 Westwood Plz Ste 8638, Los Angeles, CA 90095-4224

PECOS Enrollment

This provider is enrolled in PECOS as MELISSA STANCZAK.

Based on the most recent information from CMS, provider Melissa Elizabeth Stanczak is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1174537716
Provider Type
Individual
Full Name
Stanczak, Melissa Elizabeth
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
7/28/2006
Last Updated
3/16/2022

Contact Information

Practice Location

757 Westwood Plz Ste 8638, Los Angeles, CA 90095-4224

(310) 267-7834

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP13986 California
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP2959 Arizona

Provider Identifiers

ID	Description	Issuer
ID 301658	Description Medicaid	Issuer Unlisted Arizona
ID RN5218580	Description Medicaid	Issuer Unlisted California

Melissa Elizabeth Stanczak

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Alcantara, Aileen June

Conte, Luis Christopher

Wu, Nathaly

Modi, Ashley Lynn

Tamae, Cindy

Dunn, Gabriella

Peralta, Joyce V

De Leon, Lara Camille Siman

So, Eileen Linda

Correa, Jennifer Marie