Individual provider Active NPI

Betty C Melchor

  • Family Nurse Practitioner
  • Pleasanton, CA
National Provider Identifier
1316743255
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95034066 Issued in CA
Practice address
4634 Shearwater Rd
Pleasanton, CA 94566-4612
Phone
(925) 980-3904
NPI assigned
Feb 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95034066 CA Primary

Addresses

Primary practice location

4634 Shearwater Rd
Pleasanton, CA 94566-4612

Mailing address

4634 Shearwater Rd
Pleasanton, CA 94566-4612
Phone (925) 980-3904

Other names 1

  • Betty Cacayorin Melchor Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250507002375 CA Practitioner - Nurse Practitioner 2567989189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Nephrology Medical Group IncGroup PAC ID 1759377757, 31 clinicians

Practice addresses (Care Compare)

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-0411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95034066CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Current Accepting new patients
East Bay Nephrology Medical Group, Inc CurrentSince Mar 10, 2025 Accepting new patients
East Bay Nephrology Medical Group, Inc. CurrentSince Mar 10, 2025 Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • Direct secure messaging: betty.melchor.1@6134.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/6134/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1316743255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4634 SHEARWATER RD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945664612",
            "telephone_number": "925-980-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4634 SHEARWATER RD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945664612",
            "telephone_number": "925-980-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHOR",
        "first_name": "BETTY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETTY",
            "last_name": "MELCHOR",
            "middle_name": "CACAYORIN",
            "credential": "FNP-BC, DNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.