Individual provider Active NPI

Shannon Melcher, MD

  • Family Medicine Physician
  • Tustin, CA
National Provider Identifier
1285161968
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A160061 Issued in CA
Practice address
1451 Irvine Blvd
Tustin, CA 92780-3804
Phone
(714) 838-8878
NPI assigned
May 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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 A160061 CA Primary

Addresses

Primary practice location

1451 Irvine Blvd
Tustin, CA 92780-3804

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200730001471 CA Practitioner - Family Practice 9234462219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 5597663641, 61 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160061CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Regents of the University of Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
University of California Irvine Past Accepting new patients
Uci Medical Group Past Accepting new patients
University of California Irvine Past Accepting new patients
Uci Department of Urology Past Accepting new patients

Locations

4000 MacArthur Blvd
Ste 110
Newport Beach, CA 92660
Phone (949) 445-8768

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

1451 Irvine Blvd
Ste 100
Tustin, CA 92780

1451 Irvine Blvd
Ste 200
Tustin, CA 92780

1451 Irvine Blvd
#100
Tustin, CA 92780

1451 Irvine Blvd
Tustin, CA 92780
Phone (714) 838-8408

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1285161968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803804",
            "telephone_number": "714-838-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHER",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A160061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.