Individual provider Active NPI

Adeline Lee Melvin, M.D.

  • Pediatrics Physician
  • Denton, MD
National Provider Identifier
1164953790
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0089315 Issued in MD
Practice address
808 S 5TH Ave
Denton, MD 21629-1398
Phone
(410) 479-2650
Fax
(833) 908-2283
NPI assigned
Mar 24, 2017
Last updated
Jan 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0089315 MD Primary

Addresses

Primary practice location

808 S 5TH Ave
Denton, MD 21629-1398

Mailing address

808 S 5TH Ave
Denton, MD 21629-1398
Phone (410) 479-2650

Other practice location 1

1600 Rockland Rd
Wilmington, DE 19803-3607
Phone (302) 651-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200527001285 MD Practitioner - Pediatric Medicine 9537446984 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0089315MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choptank Community Health System Inc CurrentSince Jul 20, 2020 Accepting new patients
Choptank Community Health System Inc CurrentSince Jul 20, 2020 Accepting new patients

Locations

503 Muir St
Ste A
Cambridge, MD 21613
Phone (410) 228-4045

301 Randolph St
Denton, MD 21629
Phone (410) 479-8346

Organizations & group practices 2

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1164953790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291398",
            "telephone_number": "410-479-2650",
            "fax_number": "339-082-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291398",
            "telephone_number": "410-479-2650",
            "fax_number": "833-908-2283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Rockland Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033607",
            "country_code": "US",
            "telephone_number": "302-651-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "ADELINE",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0089315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

Verify at the official NPI Registry.