NPIMap

Individual provider Active NPI

Melissa B. Vourlitis, D.O.

  • Family Medicine Physician
  • Berkeley, CA
National Provider Identifier
1235236977
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7330 Issued in CA
Practice address
1901 4TH St
Berkeley, CA 94710-1985
Phone
(510) 929-1400
Fax
(510) 919-1414
NPI assigned
Sep 17, 2006
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7330 CA Primary

Addresses

Primary practice location

1901 4TH St
Berkeley, CA 94710-1985

Mailing address

PO Box 511250
Los Angeles, CA 90051-7805
Phone (510) 929-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051229000756 CA Practitioner - Family Practice 4587686852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pine Park Health, IncGroup PAC ID 0345670527, 21 clinicians

Practice addresses (Care Compare)

Berkeley, CA 94710
Phone (510) 929-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Park Health, Inc Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Senior Medical Associates, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Scripps Clinic Medical Group, Inc Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Locations

1901 4th St
Ste 201
Berkeley, CA 94710
Phone (469) 401-8820

22445 Cupertino Rd
Cupertino, CA 95014
Phone (408) 253-4300

11588 Via Rancho San Diego
El Cajon, CA 92019
Phone (619) 660-5718

3850 Walnut Ave
Fremont, CA 94538
Phone (341) 206-8344

1144 65th St
Ste F
Oakland, CA 94608
Phone (510) 919-1400

2810 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 299-1419

9800 Glen Center Dr
San Diego, CA 92131
Phone (858) 832-2500

1444 McAllister St
San Francisco, CA 94115
Phone (415) 305-4002

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melissa.vourlitis@299395540647940.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kara HealthAnaheim, CA, CCN A01786 Hospice Contracted Managing Employee
Operational/Managerial Control		 Feb 20, 2026
Feb 20, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 9

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1235236977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517805",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 4TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947101985",
            "telephone_number": "510-929-1400",
            "fax_number": "510-919-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOURLITIS",
        "first_name": "MELISSA",
        "middle_name": "B.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.