Individual provider Active NPI

Jeffrey A Mello, PAC

  • Surgical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1245239201
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
16836 Issued in CA
Practice address
5301 F St
Suite 111
Sacramento, CA 95819-3226
Phone
(916) 452-8291
Fax
(916) 452-1733
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA03053 TX
Surgical Physician Assistant 363AS0400X 16836 CA Primary

Addresses

Primary practice location

5301 F St
Suite 111
Sacramento, CA 95819-3226

Mailing address

5301 F St
Suite 111
Sacramento, CA 95819-3226
Phone (916) 452-8291

Other identifiers 1

IdentifierTypeStateIssuer
GR0046820MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16836CAMDClinical Social Worker
PA03053TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Cardiovascular Surgeons Medical Group Inc Past Accepting new patients
LJ Wolff Medical Corporation Past Accepting new patients

Organizations & group practices 2

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245239201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 F ST",
            "address_2": "SUITE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193226",
            "telephone_number": "916-452-8291",
            "fax_number": "916-452-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 F ST",
            "address_2": "SUITE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193226",
            "telephone_number": "916-452-8291",
            "fax_number": "916-452-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03053",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "16836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.