Individual provider Active NPI

Jonathan Melius, PA-C

  • Surgical Physician Assistant
  • Trenton, NJ
National Provider Identifier
1194034157
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00244900 Issued in NJ
Practice address
750 Brunswick Ave
Trenton, NJ 08638-4143
Phone
(609) 394-6000
NPI assigned
Sep 24, 2010
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00244900 NJ Primary

Addresses

Primary practice location

750 Brunswick Ave
Trenton, NJ 08638-4143

Mailing address

11 W Walnut Ave FL 1
Merchantville, NJ 08109-2312
Phone (518) 222-3692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121013000039 NY Practitioner - Physician Assistant 7315105228 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Dec 2, 2013 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Mar 13, 2018 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College CurrentSince Dec 2, 2013 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Stroke & Cerebrovascular Center of New Jersey PC Past Accepting new patients
Stroke & Cerebrovascular Center of New Jersey Past Accepting new patients

Locations

1365 Washington Ave
Ste 104
Albany, NY 12206
Phone (518) 675-3097

1365 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 264-1761

25 Hackett Blvd
#10
Albany, NY 12208

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

391 Myrtle Ave
Ste 1B
Albany, NY 12208
Phone (518) 264-2225

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#10A3
Albany, NY 12208

47 New Scotland Ave
Fl 3MC10
Albany, NY 12208

3 Crossing Blvd
Ste 2
Clifton Park, NY 12065
Phone (518) 264-3600

71 Prospect Ave
Ste 210
Hudson, NY 12534
Phone (518) 828-2565

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Organizations & group practices 12

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": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1194034157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W WALNUT AVE FL 1",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081092312",
            "telephone_number": "518-222-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BRUNSWICK AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384143",
            "telephone_number": "609-394-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELIUS",
        "first_name": "JONATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00244900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.