Individual provider Active NPI

Melba Colon-Renta, M.D.

  • Internal Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1306879515
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 0089265 Issued in FL
Practice address
1720 S Gadsden St
Tallahassee, FL 32301-5506
Phone
(850) 576-4073
Fax
(850) 577-0675
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 ME 0089265 FL Primary

Addresses

Primary practice location

1720 S Gadsden St
Tallahassee, FL 32301-5506

Mailing address

1720 S Gadsden St
Tallahassee, FL 32301-5506
Phone (850) 577-4073

Other practice location 1

440 W 49th St
Hialeah, FL 33012-3603
Phone (305) 828-5000

Other identifiers 1

IdentifierTypeStateIssuer
ME89265OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040923000632 FL Practitioner - Internal Medicine 9931177268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1720 S Gadsden St
Tallahassee, FL 32301-5506
Phone 8505764073212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8440PRMDPsychologist
ME 0089265FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bond Community Health Center, Inc. CurrentSince Sep 24, 2019 Accepting new patients
Bond Community Health Center, Inc. Internal Medicine CurrentSince Sep 24, 2019 Accepting new patients

Locations

1720 S Gadsden St
Tallahassee, FL 32301
Phone (850) 576-4073

Interoperability endpoints

  • Direct secure messaging: melba.colon-renta.1@14530.direct.athenahealth.com

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 1

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1306879515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 S GADSDEN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015506",
            "telephone_number": "850-577-4073",
            "fax_number": "850-577-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S GADSDEN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015506",
            "telephone_number": "850-576-4073",
            "fax_number": "850-577-0675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 W 49th St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123603",
            "country_code": "US",
            "telephone_number": "305-828-5000",
            "fax_number": "305-828-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON-RENTA",
        "first_name": "MELBA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 0089265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME89265",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.