Individual provider Active NPI

Ellen Melrose, MD

  • Dermatology Physician
  • Rifle, CO
National Provider Identifier
1225490238
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0073078 Issued in MN
Practice address
501 Airport Rd
Rifle, CO 81650-8510
Phone
(970) 625-1100
Fax
(970) 665-6678
NPI assigned
Mar 28, 2016
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0073078 MN Primary

Addresses

Primary practice location

501 Airport Rd
Rifle, CO 81650-8510

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210824002476 MN Practitioner - Dermatology 7113271784 Reassigns benefits to 1 organization
I20240625003379 CO Practitioner - Dermatology 7113271784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand River Hospital DistrictGroup PAC ID 7113837469, shared by 5 NPIs, 79 clinicians

Practice addresses (Care Compare)

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-6462

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0073078MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand River Hospital District Current Accepting new patients
Grand River Hospital District CurrentSince Aug 14, 2024 Accepting new patients
Grand River Hospital District CurrentSince Aug 14, 2024 Accepting new patients
Cardinal Pathology PC Current Accepting new patients
Grand River Hospital District Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Aug 23, 2021 Accepting new patients

Locations

201 Sipprelle Dr
Parachute, CO 81635
Phone (970) 285-5731

501 Airport Rd
Rifle, CO 81650
Phone (970) 625-1100

501 Airport Rd
Fl 2
Rifle, CO 81650
Phone (970) 625-1100

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1225490238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816508510",
            "telephone_number": "970-625-1100",
            "fax_number": "970-665-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "0073078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rifle, CO

Sources for this page

Verify at the official NPI Registry.