Kellie Melton, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35526 Issued in CA

Practice address

200 Minor Addition University of California
Berkeley, CA 94720-0001

Phone

(510) 642-2020

NPI assigned

Jun 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
  • NPI 1306908058
  Medicare reassignment NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1427733229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MINOR ADDITION UNIVERSITY OF CALIFORNIA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-642-2020",
            "fax_number": "510-642-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MINOR ADDITION UNIVERSITY OF CALIFORNIA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-642-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "KELLIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javier Omar Melendez-Vega, ASW
• Adelaida Melgoza, PPS
• Samuel Haile Melles, REGISTERED NURSE
• David Melly, L.AC.
• Richard Alan Melny, M.D.
• Roger B Mendelson, MD
• Adrian Mendez
• Alyssa Carleen Mendoza
• Tristan Eleazar Mendoza, DDS.
• Madelyn Mengarelli

• Optometrist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.