NPIMap

Individual provider Active NPI

Michael Frank Mellman, MEDICAL DOCTOR

  • Internal Medicine Physician
  • El Segundo, CA
National Provider Identifier
1427083450
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G39340 Issued in CA
Practice address
390 N Pacific Coast Hwy Ste 1065
El Segundo, CA 90245-4483
Phone
(310) 643-7494
Fax
(310) 643-7498
NPI assigned
Jul 11, 2006
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G39340 CA Primary

Addresses

Primary practice location

390 N Pacific Coast Hwy Ste 1065
El Segundo, CA 90245-4483

Mailing address

390 N Sepulveda Blvd
Suite 1065
El Segundo, CA 90245-4475
Phone (310) 643-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060811000464 CA Practitioner - Internal Medicine 5597768507 Receives reassigned benefits from 1 practitioner
Practice locations: El Segundo, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

390 N Sepulveda Blvd
Suite 1065
El Segundo, CA 90245-4483
Phone (310) 643-7494

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.56 of 100Reported as group
Quality
66.72
Improvement activities
40
Cost
79.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Mellman Mediccal Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmellman212305@direct.cshs.org

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1427083450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N SEPULVEDA BLVD",
            "address_2": "SUITE 1065",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454475",
            "telephone_number": "310-643-7494",
            "fax_number": "310-643-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N PACIFIC COAST HWY STE 1065",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454483",
            "telephone_number": "310-643-7494",
            "fax_number": "310-643-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLMAN",
        "first_name": "MICHAEL",
        "middle_name": "FRANK",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G39340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.