Individual provider Active NPI

Michael Alfred Mellenthin Jr., M.D.

  • Anesthesiology Physician
  • Fresno, CA
National Provider Identifier
1225172745
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G58951 Issued in CA
Practice address
Fresno & R Street
Fresno, CA 93721
Phone
(559) 459-6000
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G58951 CA Primary

Addresses

Primary practice location

Fresno & R Street
Fresno, CA 93721

Mailing address

PO Box 45123
San Francisco, CA 94145-7733
Phone (209) 956-7725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080228000372 CA Practitioner - Anesthesiology 9032293055 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G58951CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince May 1, 2017 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince May 1, 2017 Accepting new patients
Dental Surgery Centers of America Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Redwood Anesthesia Services, a Medical Corporation Anesthesiology Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Sequoia Health Services Past Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

400 Forest Ave
Palo Alto, CA 94301
Phone (650) 289-1208

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

Organizations & group practices 8

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1225172745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45123",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941457733",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FRESNO & R STREET",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93721",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLENTHIN",
        "first_name": "MICHAEL",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G58951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.