Individual provider Active NPI

Julia A Melamed, M.D.

  • Internal Medicine Physician
  • Deerfield, IL
National Provider Identifier
1235217373
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036095792 Issued in IL
Practice address
707 Lake Cook Rd
Suite 130
Deerfield, IL 60015-5613
Phone
(847) 418-3308
Fax
(847) 418-3309
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036095792 IL Primary

Addresses

Primary practice location

707 Lake Cook Rd
Suite 130
Deerfield, IL 60015-5613

Mailing address

707 Lake Cook Rd Ste 295
Deerfield, IL 60015-4932
Phone (847) 418-3308

Other identifiers 1

IdentifierTypeStateIssuer
036095792MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL proviewcaqh Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050711000407 IL Practitioner - Internal Medicine 3971539180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

707 Lake Cook Rd
Suite 295
Deerfield, IL 60015-4932
Phone (847) 418-3308

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
JB Medical Inc Internal Medicine CurrentSince Dec 1, 2010 Accepting new patients

Locations

707 Lake Cook Rd
Ste 295
Deerfield, IL 60015
Phone (847) 418-3308

707 Lake Cook Rd
Ste 130
Deerfield, IL 60015
Phone (847) 498-4998

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1235217373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 LAKE COOK RD STE 295",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154932",
            "telephone_number": "847-418-3308",
            "fax_number": "847-418-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 LAKE COOK RD",
            "address_2": "SUITE 130",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155613",
            "telephone_number": "847-418-3308",
            "fax_number": "847-418-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAMED",
        "first_name": "JULIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095792",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "proviewcaqh",
            "affiliation": "N",
            "endpointDescription": "caqh",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "707 Lake Cook Rd Ste 295",
            "city": "Deerfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600154932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

Verify at the official NPI Registry.