Individual provider Active NPI

Jason V Melillo, M.D.

  • Obstetrics & Gynecology Physician
  • Columbus, OH
National Provider Identifier
1164510228
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35075115 Issued in OH
Practice address
1315 W Lane Ave
Suite D
Columbus, OH 43221-3538
Phone
(614) 457-4827
Fax
(614) 457-4832
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35075115 OH Primary

Addresses

Primary practice location

1315 W Lane Ave
Suite D
Columbus, OH 43221-3538

Mailing address

1315 W Lane Ave
Suite D
Columbus, OH 43221-3538
Phone (614) 457-4827

Other identifiers 2

IdentifierTypeStateIssuer
2290346MedicaidOH
4166851OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040128000828 OH Practitioner - Obstetrics/Gynecology 6507769544 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince May 27, 2012 Accepting new patients
Maternohio Clinical Associates LLC CurrentSince Oct 1, 2005 Accepting new patients
Ohiohealth Corporation Obstetrics & Gynecology Current Accepting new patients
Ohiohealth Corporation CurrentSince May 27, 2012 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1315 W Lane Ave
Ste D
Columbus, OH 43221
Phone (614) 457-4827

Dept L3652
Columbus, OH 43260

1241 Dublin Rd
Ste 200
Columbus, OH 43215
Phone (614) 255-5349

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

10244 Sawmill Pkwy
Powell, OH 43065
Phone (614) 457-4827

Interoperability endpoints

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

Organizations & group practices 5

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1164510228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W LANE AVE",
            "address_2": "SUITE D",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213538",
            "telephone_number": "614-457-4827",
            "fax_number": "614-457-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W LANE AVE",
            "address_2": "SUITE D",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213538",
            "telephone_number": "614-457-4827",
            "fax_number": "614-457-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELILLO",
        "first_name": "JASON",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35075115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2290346",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4166851",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.