Individual provider Active NPI

Melanie A. Farrell, M.D.

  • Nephrology Physician
  • La Jolla, CA
National Provider Identifier
1144322850
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G61110 Issued in CA
Practice address
9834 Genesee Ave
Suite 312
La Jolla, CA 92037-1223
Phone
(858) 558-8150
Fax
(858) 346-1024
NPI assigned
Sep 2, 2006
Last updated
Sep 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G61110 CA Primary

Addresses

Primary practice location

9834 Genesee Ave
Suite 312
La Jolla, CA 92037-1223

Mailing address

9610 Granite Ridge Dr
Ste B
San Diego, CA 92123-2684
Phone (858) 810-8000

Other identifiers 4

IdentifierTypeStateIssuer
00G611100MedicaidCA
00G611100OtherCABLUE SHIELD
CD880ZOtherCASO. CALIFORNIA PTAN
CA127954OtherCANO. CALIFORNIA PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G61110CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graybill Medical Group Inc CurrentSince Jul 1, 2017 Accepting new patients
North County Vascular Center a Ca Professional Medical Corporation PastSince Feb 5, 2013 Accepting new patients

Locations

625 E Grand Ave
Escondido, CA 92025
Phone (760) 745-1551

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1144322850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 GRANITE RIDGE DR",
            "address_2": "STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232684",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 312",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-558-8150",
            "fax_number": "858-346-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "MELANIE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G61110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G611100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G611100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SO. CALIFORNIA PTAN",
            "identifier": "CD880Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO. CALIFORNIA PTAN",
            "identifier": "CA127954",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.