Individual provider Active NPI

A. Melinda Liller, MD

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1386630002
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2021014589 Issued in MO
Practice address
70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 334-6071
Fax
(219) 738-6714
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2021014589 MO Primary

Addresses

Primary practice location

70 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Other names 1

  • Alice Melinda Liller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20060522000094 IN Practitioner - Diagnostic Radiology 4284529900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Michigan Medical School, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Radiology P CGroup PAC ID 0143295410, 101 clinicians

Practice addresses (Care Compare)

7221 Engle Rd
Suite 220
Fort Wayne, IN 46804-2233
Phone (260) 432-1568

Hospital & facility affiliations

  • Woodlawn Hospital Hospital, Rochester, IN, CCN 151313
  • Ascension St Vincent Clay Hospital, Brazil, IN, CCN 151309
  • Ascension St Vincent Salem Hospital, Salem, IN, CCN 151314
  • Ascension St Vincent Williamsport Hospital, Williamsport, IN, CCN 151307
  • Ascension St Vincent Jennings Hospital, North Vernon, IN, CCN 151303

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
92.18
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021014589MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle Diagnostic Radiology CurrentSince Jan 14, 2026 Accepting new patients
Summit Radiology P C Diagnostic Radiology CurrentSince Aug 13, 2023 Accepting new patients
Franciscan Physician Network Past Accepting new patients
Franciscan Health Munster Past Accepting new patients
Medical Specialists Inc., PC Past Accepting new patients

Locations

7221 Engle Rd
Ste 220
Fort Wayne, IN 46804
Phone (503) 413-7127

5001 US Highway 30 W
#D
Fort Wayne, IN 46818
Phone (808) 599-4471

Organizations & group practices 5

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 5

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1386630002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "219-738-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "219-738-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLER",
        "first_name": "A.",
        "middle_name": "MELINDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2021014589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "LILLER",
            "middle_name": "MELINDA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.