Individual provider Active NPI

Michael David Mello, MD

  • Gastroenterology Physician
  • Glendale, CA
National Provider Identifier
1356571566
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A135756 Issued in CA
Practice address
1818 Verdugo Blvd
Suite 107
Glendale, CA 91208-1400
Phone
(818) 790-0122
Fax
(818) 790-4623
NPI assigned
Jul 22, 2009
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A135756 CA Primary

Addresses

Primary practice location

1818 Verdugo Blvd
Suite 107
Glendale, CA 91208-1400

Mailing address

1818 Verdugo Blvd
Suite 107
Glendale, CA 91208-1400
Phone (818) 790-0122

Other names 1

  • Michael D Mello Professional 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160714002081 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 3678703287 Reassigns benefits to 1 organization
Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Southern California Keck School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1818 Verdugo Blvd
Suite 107
Glendale, CA 91208-1400
Phone (818) 790-0122

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy366
Upper gastrointestinal (GI) endoscopy for acid reflux553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A135756CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W. David Mello, M.D., Inc.,a Professional Corporation Gastroenterology CurrentSince May 24, 2023 Accepting new patients
Michael D. Mello, M.D., a Professional Corporation Gastroenterology CurrentSince May 24, 2023 Accepting new patients
Dignity Health Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

1818 Verdugo Blvd
Ste 107
Glendale, CA 91208
Phone (818) 790-0122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24355/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/1ac545fd-ef52-46ef-9d44-79bace12a10b/
  • Direct secure messaging: michael.mello.1@24355.direct.athenahealth.com

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

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1356571566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 107",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081400",
            "telephone_number": "818-790-0122",
            "fax_number": "818-790-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 107",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081400",
            "telephone_number": "818-790-0122",
            "fax_number": "818-790-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A135756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "MELLO",
            "middle_name": "D",
            "credential": "MD, APC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.