NPIMap

Individual provider Active NPI

Todd D Mellish, DO

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1255380044
Registry record updated Feb 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11330 Issued in NH
Practice address
4 Elliot Way
Ste 102
Manchester, NH 03103-3551
Phone
(603) 626-5900
Fax
(603) 625-2180
NPI assigned
May 9, 2006
Last updated
Feb 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 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 11330 NH Primary

Addresses

Primary practice location

4 Elliot Way
Ste 102
Manchester, NH 03103-3551

Mailing address

6 Tsienneto Rd
Ste 300
Derry, NH 03038-1584
Phone (603) 216-0400

Other identifiers 1

IdentifierTypeStateIssuer
01YP03381NH03OtherANTHEM NH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040929000784 NH Practitioner - Internal Medicine 9739158437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern New Hampshire Internal Medicine Associates PCGroup PAC ID 9133111990, 16 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

160 S River Rd
Bedford, NH 03110-6927
Phone (603) 626-4000

20009 Verdana Village Blvd
Unit 103
Estero, FL 33928-9826
Phone (419) 221-6717

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern New Hampshire Internal Medicine Associates, PLLC CurrentSince Apr 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

160 S River Rd
Bedford, NH 03110
Phone (603) 314-7560

160 S River Rd
Ste 101A
Bedford, NH 03110
Phone (603) 216-3800

6 Tsienneto Rd
Ste 300
Derry, NH 03038
Phone (603) 216-0479

49 Range Rd
Ste 110
Windham, NH 03087

Interoperability endpoints

  • Direct secure messaging: toddmellish@snhima.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550275200000",
    "number": "1255380044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "STE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ELLIOT WAY",
            "address_2": "STE 102",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033551",
            "telephone_number": "603-626-5900",
            "fax_number": "603-625-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLISH",
        "first_name": "TODD",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "11330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM NH",
            "identifier": "01YP03381NH03",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.