Michael D. Mello, M.D., a Professional Corporation

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MICHAEL D. MELLO, M.D., A PROFESSIONAL CORPORATION

Practice address

1818 Verdugo Blvd Ste 107
Glendale, CA 91208-1400

Phone

(818) 790-0122

Fax

(818) 790-4623

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Barbara Susan Mello

Title

Office Manager/Corporate Secretary

Phone

(818) 790-0122

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24355/brand/2/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael David Mello, MD

  • Gastroenterology Physician
  • Glendale, CA
  • NPI 1356571566
  Medicare reassignment NPD
• Evelyn Ortiz Marquez, MD

  • Student in an Organized Health Care Education/Training Program
  • Dallas, TX
  • NPI 1356571863
  NPD (past)

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1407557408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD STE 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 STE 107",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081400",
            "telephone_number": "818-790-0122",
            "fax_number": "818-790-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. MELLO, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "MELLO",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER/CORPORATE SECRETARY",
        "authorized_official_telephone_number": "818-790-0122"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Aida Michaelian
• Denise Michele, D.C.

• Gastroenterology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.