Individual provider Active NPI

Constantine Melitas, M.D.

  • Gastroenterology Physician
  • Santa Maria, CA
National Provider Identifier
1154731321
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A167829 Issued in CA
Practice address
1325 E Church St Ste 202
Santa Maria, CA 93454-5915
Phone
(805) 346-3456
Fax
(805) 346-3454
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A167829 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1325 E Church St Ste 202
Santa Maria, CA 93454-5915

Mailing address

1325 E Church St Ste 202
Santa Maria, CA 93454-5915
Phone (805) 434-5530

Other practice location 1

850 Fair Oaks Ave Ste 220
Arroyo Grande, CA 93420-3929
Phone (805) 434-5530

Other practice location 2

1304 Ella St Ste A
San Luis Obispo, CA 93401-4165
Phone (805) 549-9555

Other practice location 3

350 Posada Ln Ste 202
Templeton, CA 93465-4060
Phone (805) 434-5497

Other practice location 4

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Other practice location 5

2650 Ridge Avenue
Evanston, IL 60201
Phone (847) 570-2509

Other practice location 6

316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908
Phone (805) 332-8446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816000874 CA Practitioner - Gastroenterology 5395048359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

316 S Stratford Ave
Suite B
Santa Maria, CA 93454-5908
Phone (805) 332-8446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy107
Upper gastrointestinal (GI) endoscopy for acid reflux615

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Sep 13, 2021 Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers CurrentSince Sep 13, 2021 Accepting new patients
Dignity Health Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
Dignity Community Care Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

850 Fair Oaks Ave
Ste 220
Arroyo Grande, CA 93420
Phone (805) 434-5530

2 James Way
Ste 207
Pismo Beach, CA 93449
Phone (805) 434-5530

1325 E Church St
Ste 202
Santa Maria, CA 93454
Phone (805) 346-3456

316 S Stratford Ave
Ste B
Santa Maria, CA 93454
Phone (805) 332-8446

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1304 Ella St
Ste A
Sn Luis Obisp, CA 93401
Phone (805) 541-1060

350 Posada Ln
Ste 202
Templeton, CA 93465
Phone (805) 434-5497

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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 4

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1154731321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST STE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545915",
            "telephone_number": "805-434-5530",
            "fax_number": "805-556-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST STE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545915",
            "telephone_number": "805-346-3456",
            "fax_number": "805-346-3454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Fair Oaks Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203929",
            "country_code": "US",
            "telephone_number": "805-434-5530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 Ella St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934014165",
            "country_code": "US",
            "telephone_number": "805-549-9555",
            "fax_number": "805-549-0444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Posada Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654060",
            "country_code": "US",
            "telephone_number": "805-434-5497",
            "fax_number": "805-434-0917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16001 W 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754818",
            "country_code": "US",
            "telephone_number": "248-849-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 Ridge Avenue",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60201",
            "country_code": "US",
            "telephone_number": "847-570-2509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 S Stratford Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545908",
            "country_code": "US",
            "telephone_number": "805-332-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELITAS",
        "first_name": "CONSTANTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A167829",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.