Individual provider Active NPI

Andrey Melnikov, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1164719613
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
135000744 Issued in IL
Practice address
3631 N Harlem Ave
Chicago, IL 60634-2237
Phone
(773) 725-2953
NPI assigned
Jul 6, 2011
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 135000744 IL Primary

Addresses

Primary practice location

3631 N Harlem Ave
Chicago, IL 60634-2237

Mailing address

3631 N Harlem Ave
Chicago, IL 60634-2237
Phone (847) 530-2476

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140617002165 IL Practitioner - Podiatry 2860616620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Footcare at Home PC.Group PAC ID 2163522616, 9 clinicians

Practice addresses (Care Compare)

3631 N Harlem Ave
Chicago, IL 60634-2237
Phone (773) 725-2953

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue56
Removal of nail tissue1474
Removal or shaving of skin growth262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135000744ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alm Podiatry PC Foot & Ankle Surgery CurrentSince Jun 27, 2015 Accepting new patients
Footcare at Home PC Foot & Ankle Surgery CurrentSince May 1, 2024 Accepting new patients
Foot & Ankle Health Care Center LTD Past Accepting new patients

Locations

3631 N Harlem Ave
Chicago, IL 60634
Phone (773) 653-2118

900 Ogden Ave
Downers Grove, IL 60515
Phone (773) 234-0388

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1164719613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342237",
            "telephone_number": "847-530-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342237",
            "telephone_number": "773-725-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELNIKOV",
        "first_name": "ANDREY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135000744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.