Individual provider Active NPI

Marcello M. Mellino, MD

  • Cardiovascular Disease Physician
  • Fairview Park, OH
National Provider Identifier
1003862335
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35041218 Issued in OH
Practice address
20455 Lorain Rd
Second Floor
Fairview Park, OH 44126-3494
Phone
(440) 333-8600
Fax
(440) 333-5015
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35041218 OH Primary

Addresses

Primary practice location

20455 Lorain Rd
Second Floor
Fairview Park, OH 44126-3494

Mailing address

20455 Lorain Rd
Second Floor
Fairview Park, OH 44126-3494
Phone (440) 333-8600

Other identifiers 1

IdentifierTypeStateIssuer
0429450MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000001 OH Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5991603805 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Oct 8, 2013 Accepting new patients
Fairview Hospital Cardiovascular Disease CurrentSince Oct 8, 2013 Accepting new patients

Locations

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

Organizations & group practices 2

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1003862335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD",
            "address_2": "SECOND FLOOR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263494",
            "telephone_number": "440-333-8600",
            "fax_number": "440-333-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD",
            "address_2": "SECOND FLOOR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263494",
            "telephone_number": "440-333-8600",
            "fax_number": "440-333-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLINO",
        "first_name": "MARCELLO",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35041218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0429450",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.