Active NPI
Melanie A. Farrell, M.D.
- Nephrology Physician
- La Jolla, CA
National Provider Identifier
1144322850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- G61110
- 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, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G611100 | Medicaid | CA | |
| 00G611100 | Other | CA | BLUE SHIELD |
| CD880Z | Other | CA | SO. CALIFORNIA PTAN |
| CA127954 | Other | CA | NO. 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
| License | State | Type | Specialty |
|---|---|---|---|
| G61110 | CA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graybill Medical Group Inc | Current | Accepting new patients | |
| North County Vascular Center a Ca Professional Medical Corporation | Past | Accepting new patients |
Locations
625 E Grand Ave
Escondido, CA 92025
Phone (760) 745-1551
Interoperability endpoints
- 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.
-
- Nephrology Physician
- La Jolla, CA
- NPI 1689719551
-
- Family Medicine Physician
- Escondido, CA
- NPI 1891729745
-
- Vascular & Interventional Radiology Physician
- Escondido, CA
- NPI 1881930949
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.