Individual provider Active NPI

Matthew Birk Mellon, M.D.

  • Orthopaedic Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1336302504
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
62217 Issued in WI
Practice address
2801 W KK River Pkwy
Suite 345
Milwaukee, WI 53215-3669
Phone
(414) 649-7900
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X BP10026870 TX
Orthopaedic Trauma Physician 207XX0801X 261768 NY
Orthopaedic Trauma Physician 207XX0801X MD440658 PA
Orthopaedic Trauma Physician 207XX0801X A120685 CA
Orthopaedic Surgery Physician 207X00000X 62217 WI Primary

Addresses

Primary practice location

2801 W KK River Pkwy
Suite 345
Milwaukee, WI 53215-3669

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmellon118462@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20140630000876 WI Practitioner - Orthopedic Surgery 6507035060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Suite 345
Milwaukee, WI 53215-3669
Phone (414) 649-7900

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5950

9120 W Loomis Rd
Suite 100
Franklin, WI 53132-9083
Phone (414) 858-1740

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement13
Knee replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10026870TXMDOrthopaedic Surgery Physician
62217WIMDOrthopaedic Surgery Physician
A120685CAMDOrthopaedic Trauma Physician
261768NYMDOrthopaedic Trauma Physician
MD440658PAMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Aug 1, 2014 Accepting new patients
Aurora Advanced Healthcare, Inc. Orthopaedic Surgery CurrentSince Aug 1, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2014 Accepting new patients

Locations

9120 W Loomis Rd
Ste 100
Franklin, WI 53132
Phone (262) 939-9318

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Ste 370
Milwaukee, WI 53215
Phone (414) 649-1280

945 N 12th St
Ste 102
Milwaukee, WI 53233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: mmellon118462@direct.myadvocateaurora.org

Organizations & group practices 4

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 6

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1336302504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KK RIVER PKWY",
            "address_2": "SUITE 345",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLON",
        "first_name": "MATTHEW",
        "middle_name": "BIRK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "BP10026870",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NY",
            "license": "261768",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "PA",
            "license": "MD440658",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CA",
            "license": "A120685",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "62217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmellon118462@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kk River Pkwy",
            "address_2": "Suite 345",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kk River Pkwy",
            "address_2": "Suite 345",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.