Active NPI
Michael George Melkonian, M.D.
- Surgery Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 300100744
- Practice address
- 2104 Randolph Rd
Charlotte, NC 28207-1522 - Phone
- (704) 377-3900
- Fax
- (704) 377-1244
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 300100744 | NC | Primary |
Addresses
Primary practice location
2104 Randolph Rd
Charlotte, NC 28207-1522
Mailing address
2104 Randolph Road
Charlotte, NC 28207-1522
Phone (704) 377-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89129GP | Medicaid | NC | |
| 129GP | Other | NC | BLUE CROSS & BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmelkonian46492@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Medical College of Wisconsin, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9735 Kincey Ave
Suite 205
Huntersville, NC 28078-9120
Phone (704) 316-5523
Hospital & facility affiliations
- Novant Health Matthews Medical Center
- Novant Health Presbyterian Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 41 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300100744 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Medical Group Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350
2104 Randolph Rd
Charlotte, NC 28207
Phone (704) 344-3900
19830 Zion Ave
Cornelius, NC 28031
Phone (704) 384-1782
9735 Kincey Ave
Ste 205
Huntersville, NC 28078
Phone (704) 316-5523
1450 Matthews Township Pkwy
Ste 230
Matthews, NC 28105
Phone (704) 384-8615
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Cardiovascular Disease Physician
- Jefferson, NC
- NPI 1952739450
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Matthews, NC
- NPI 1063463156
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1366540650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 RANDOLPH ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071522",
"telephone_number": "704-377-3900",
"fax_number": "704-377-1244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 RANDOLPH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071522",
"telephone_number": "704-377-3900",
"fax_number": "704-377-1244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELKONIAN",
"first_name": "MICHAEL",
"middle_name": "GEORGE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2020-10-25",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "300100744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89129GP",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "129GP",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmelkonian46492@direct.novanthealth.org",
"affiliation": "N",
"address_1": "2104 Randolph Rd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282071522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.