Stacey Wayne Melnick, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

201350068NP Issued in OR

Practice address

1675 SW Marlow Ave Ste 202
Portland, OR 97225

Phone

(503) 430-1777

NPI assigned

Apr 15, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Altea Medical Oregon LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1184451254
  Medicare reassignment NPD
• CRM Physicians, LLC

  dba Ascent Healthcare

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996

  Adult Health

  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  OR

  Medicare reassignment NPD
• Mark W Cheng LLC

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
  • NPI 1497251904
  NPD (past)

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1235572744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102",
            "telephone_number": "503-430-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-430-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELNICK",
        "first_name": "STACEY",
        "middle_name": "WAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201350068NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Mello, PHARMD
• Margret Lee Mellon, LMT
• Michael D. Mellum, D.M.D.
• Nicholas Ryan Mellum, DMD
• Mark A Melman, MD
• Lauren Michelle Melnik, AGACNP
• Alisa Melnikova, CRNA
• Ryka Melnyczenko, MSW
• Clifford Stephen Melnyk, MD
• Veronica Melo Najera, MSW

• Adult Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.