Individual provider Active NPI

Mia Melillo Horvath, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mesa, AZ
National Provider Identifier
1083840318
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0750 Issued in AZ
Practice address
1620 S Stapley Dr Ste 132
Mesa, AZ 85204-6655
Phone
(480) 834-8804
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0750 AZ Primary

Addresses

Primary practice location

1620 S Stapley Dr Ste 132
Mesa, AZ 85204-6655

Mailing address

1620 S Stapley Dr Ste 132
Mesa, AZ 85204-6655
Phone (480) 834-8804

Other names 1

  • Mia Katherine Melillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907000633 OR Practitioner - Podiatry 8022267020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Extremity Specialists LLCGroup PAC ID 3577881747, 21 clinicians

Practice addresses (Care Compare)

9115 SW Oleson Rd
Suite 205
Portland, OR 97223-6877
Phone (503) 245-2420

Hospital & facility affiliations

  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue82
Removal of skin lesions1-10
Removal of nail tissue723
Removal or shaving of skin growth289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Extremity Specialists LLC CurrentSince Sep 1, 2016 Accepting new patients
Northwest Extremity Specialists LLC Podiatrist CurrentSince Sep 1, 2016 Accepting new patients
Podiatric Physicians of Arizona, Inc. Foot & Ankle Surgery Past Accepting new patients
Podiatric Physicians of Arizona, Inc. Foot & Ankle Surgery Past Accepting new patients

Locations

201 N Washington St
Newberg, OR 97132
Phone (503) 538-0800

6542 SE Lake Rd
Ste 102
Portland, OR 97222
Phone (503) 659-6686

9900 SW Hall Blvd
Ste 100
Tigard, OR 97223

9115 SW Oleson Rd
Ste 205
Tigard, OR 97223
Phone (503) 243-5710

Interoperability endpoints

  • Direct secure messaging: mia.horvath@358.chartlogic.direct-ci.com
  • Direct secure messaging: mia.horvath@pfac.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1083840318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S STAPLEY DR STE 132",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046655",
            "telephone_number": "480-834-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S STAPLEY DR STE 132",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046655",
            "telephone_number": "480-834-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORVATH",
        "first_name": "MIA",
        "middle_name": "MELILLO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "MELILLO",
            "middle_name": "KATHERINE",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.