Individual provider Active NPI

Melinda Ann Sanfilippo, BSN, MSN, FNP-C.

  • Family Nurse Practitioner
  • Forest Grove, OR
National Provider Identifier
1215053277
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014408826NP-PP FAMI Issued in OR
Practice address
4363 SW Anderson Rd
Forest Grove, OR 97116-8530
Phone
(503) 708-6112
Fax
(503) 352-9639
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014408826NP-PP FAMI OR Primary

Addresses

Primary practice location

4363 SW Anderson Rd
Forest Grove, OR 97116-8530

Mailing address

4363 SW Anderson Rd
Forest Grove, OR 97116-8530
Phone (503) 708-6112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150305000068 OR Practitioner - Nurse Practitioner 4688990922 Reassigns benefits to 2 organizations
Practice locations: Forest Grove, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2014408826NP-PP FAMIORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Northwest CurrentSince Dec 1, 2017 Accepting new patients
Marc E. Lewis MD LLC CurrentSince Apr 1, 2015 Accepting new patients
Forest Grove Healthcare, LLC PastSince Dec 27, 2014 Accepting new patients

Locations

2221 Oak St
Forest Grove, OR 97116
Phone (503) 359-4465

356 SE 9th Ave
Hillsboro, OR 97123
Phone (503) 647-9261

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1215053277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 SW ANDERSON RD",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971168530",
            "telephone_number": "503-708-6112",
            "fax_number": "503-352-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4363 SW ANDERSON RD",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971168530",
            "telephone_number": "503-708-6112",
            "fax_number": "503-352-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFILIPPO",
        "first_name": "MELINDA",
        "middle_name": "ANN",
        "credential": "BSN, MSN, FNP-C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "2014408826NP-PP FAMI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

Verify at the official NPI Registry.