Jared Joseph Mell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59756 Issued in MN

Practice address

8455 Flying Cloud Dr
Eden Prairie, MN 55344

Phone

(952) 993-7400

NPI assigned

Apr 18, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1912315144
  NPD

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1063832921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD",
            "address_2": "SUITE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 FLYING CLOUD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-993-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELL",
        "first_name": "JARED",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicura Transport Solutions
• Mediride LLC
• Allen James Meglin, M.D.
• Bradley Meilinger
• Norman Billings Mekkelsen III, NP
• Cynthia M Mellang, RPH
• Michelle Karen Melotti, M.D.
• Robin Melville
• John Mendiola
• Weedor M. Menniboe I

• Family Medicine Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.