Timothy J Mello, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0550030562 Issued in VT

Practice address

29 Ridgewood Rd
Springfield, VT 05156-3050

Phone

(802) 885-6373

Fax

(802) 885-6376

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in VT, NH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Yale University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Hospital Inc.Group PAC ID 6507760337, shared by 4 NPIs, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Springfield Hospital Hospital, Springfield, VT, CCN 471306

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothymello@nms.allscriptsdirect.net

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.

• Springfield Hospital

  • Critical Access Hospital Clinic/Center
  • Springfield, VT
  • NPI 1033225875
  Medicare reassignment NPD
• Springfield Hospital Inc

  • Anesthesiology Physician
  • Springfield, VT
  • NPI 1780657783

  NH

  Medicare reassignment NPD
• Springfield Hospital .Inc

  • Critical Access Hospital
  • Springfield, VT
  • NPI 1982743969
  NPD

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

• Springfield Hospital

  • Critical Access Hospital Clinic/Center
  • Springfield, VT
  • NPI 1033225875
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1093726366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 RIDGEWOOD RD",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051563050",
            "telephone_number": "802-885-6373",
            "fax_number": "802-885-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 RIDGEWOOD RD",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051563050",
            "telephone_number": "802-885-6373",
            "fax_number": "802-885-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "0550030562",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0416P",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VT",
            "license": "0550030562",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0416P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "58641",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "341729",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "228223",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VN1017",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30334363",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne McGrath, P.T.
• Olivia McIntyre
• Shannon McKenna
• Carl McNeely, APRN, PNP
• Amy Catherine McPheters, MS LCMHC
• Lila Ann Menzi, MSN, FNP-C
• Kathy-Jo Merlau, LCMHC, LADC
• Alexander Merseal
• Leah Meserve, BA
• Brittany Metivier

• Physician Assistant in Springfield, VT
• Providers in Springfield, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.
• 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.