Individual provider Active NPI

Yelena Melyakova, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Farmington, MO
National Provider Identifier
1386691871
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2005022499 Issued in MO
Practice address
1103 W Liberty St
Farmington, MO 63640-1921
Phone
(573) 756-6751
Fax
(573) 756-3495
NPI assigned
May 28, 2006
Last updated
Aug 7, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2005022499 MO Primary

Addresses

Primary practice location

1103 W Liberty St
Farmington, MO 63640-1921

Mailing address

1103 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20141008002165 DC Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4082610944 Practice locations: Bethesda, MD

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Geriatric Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1386691871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401921",
            "telephone_number": "573-756-6751",
            "fax_number": "573-756-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401921",
            "telephone_number": "573-756-6751",
            "fax_number": "573-756-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELYAKOVA",
        "first_name": "YELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2005022499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.