Individual provider Active NPI

Julienne Yuchan Melanio, PT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1023081239
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20540 Issued in FL
Practice address
1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone
(863) 680-7700
Fax
(866) 264-8519
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20540 FL Primary

Addresses

Primary practice location

1430 Lakeland Hills Blvd
Lakeland, FL 33805

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Other identifiers 1

IdentifierTypeStateIssuer
888140500MedicaidFL

Other names 1

  • Julienne J. Yuchan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmelanio6733@direct.watsonclinicad.com Watson Clinic LLP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080701000511 FL Practitioner - Physical Therapist in Private Practice 0749352029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1430 Lakeland Hills Blvd
Lakeland, FL 33805-3202
Phone (863) 680-7337

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20540FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP CurrentSince Apr 1, 2008 Accepting new patients
Watson Clinic LLP Past Accepting new patients

Locations

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

2190 E County Road 540A
Lakeland, FL 33813
Phone (863) 607-3699

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1023081239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-680-7700",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELANIO",
        "first_name": "JULIENNE",
        "middle_name": "YUCHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888140500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmelanio6733@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIENNE",
            "last_name": "YUCHAN",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.