Individual provider Active NPI

Melindres J Lim, M.D.

  • Pediatrics Physician
  • La Grande, OR
National Provider Identifier
1386688349
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD29069 Issued in OR
Practice address
612 Sunset Dr
La Grande, OR 97850-1248
Phone
(541) 663-3150
Fax
(541) 975-5111
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD29069 OR Primary
Pediatrics Physician 208000000X MA61225 NJ

Addresses

Primary practice location

612 Sunset Dr
La Grande, OR 97850-1248

Mailing address

612 Sunset Dr
La Grande, OR 97850-1248
Phone (541) 663-3150

Other identifiers 1

IdentifierTypeStateIssuer
6994008MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110228000915 OR Practitioner - Pediatric Medicine 7214118942 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA61225NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Jan 4, 2026 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Jan 4, 2026 Accepting new patients
Westside Pediatrics,P.a. Pediatrics Past Accepting new patients

Locations

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

612 Sunset Dr
La Grande, OR 97850
Phone (541) 663-3150

710 Sunset Dr
Ste E
La Grande, OR 97850
Phone (541) 663-3150

710 Sunset Dr
Ste F
La Grande, OR 97850
Phone (541) 663-3100

Interoperability endpoints

  • Direct secure messaging: mlim834880@wm.providencedirect.org

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1386688349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501248",
            "telephone_number": "541-663-3150",
            "fax_number": "541-975-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501248",
            "telephone_number": "541-663-3150",
            "fax_number": "541-975-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "MELINDRES",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD29069",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA61225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6994008",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.