Individual provider Active NPI

Melchior P. Vallone, DPM

  • Podiatrist
  • La Mesa, CA
National Provider Identifier
1093998965
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2201 Issued in CA
Practice address
5129 Garfield St
La Mesa, CA 91941-5103
Phone
(619) 465-3200
Fax
(619) 465-3700
NPI assigned
Dec 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2201 CA Primary

Addresses

Primary practice location

5129 Garfield St
La Mesa, CA 91941-5103

Mailing address

5129 Garfield St
La Mesa, CA 91941-5103
Phone (619) 465-3200

Other identifiers 3

IdentifierTypeStateIssuer
000E22010OtherBC
756480533OtherRR MEDICARE
1165019MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000202 CA Practitioner - Podiatry 2365565405 Reassigns benefits to 1 organization
Practice locations: El Cajon, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2201CAMDPodiatrist
2201CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grossmont Hospital Corporation Past Accepting new patients
Sycuan Tribal Government Past Accepting new patients

Organizations & group practices 3

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1093998965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5129 GARFIELD ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415103",
            "telephone_number": "619-465-3200",
            "fax_number": "619-465-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 GARFIELD ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415103",
            "telephone_number": "619-465-3200",
            "fax_number": "619-465-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLONE",
        "first_name": "MELCHIOR",
        "middle_name": "P.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "000E22010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "756480533",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1165019",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.