Individual provider Active NPI

Erika D. Mello, D.O.

  • Internal Medicine Physician
  • Fall River, MA
National Provider Identifier
1467576298
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
231624 Issued in MA
Practice address
1565 N Main St Ste 306
Fall River, MA 02720-2972
Phone
(508) 973-9500
Fax
(508) 973-0351
NPI assigned
Mar 19, 2007
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 231624 MA Primary

Addresses

Primary practice location

1565 N Main St Ste 306
Fall River, MA 02720-2972

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-9500

Other identifiers 1

IdentifierTypeStateIssuer
2141281MedicaidMA

Other names 1

  • Erika D. Bradford Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emello42985@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20070920000619 MA Practitioner - Internal Medicine 5193761799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1565 N Main St
Suite 306
Fall River, MA 02720-2972
Phone (508) 973-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231624MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Apr 6, 2018 Accepting new patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Sep 4, 2007 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Apr 6, 2018 Accepting new patients

Locations

545 Bedford St
Bridgewater, MA 02324
Phone (508) 697-3677

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

1565 N Main St
Ste 306
Fall River, MA 02720
Phone (508) 675-0369

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

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

Hospital & facility affiliations 2

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1467576298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-9500",
            "fax_number": "508-973-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 N MAIN ST STE 306",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202972",
            "telephone_number": "508-973-9500",
            "fax_number": "508-973-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "ERIKA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "231624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2141281",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emello42985@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "1565 N Main St Ste 306",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027202972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "BRADFORD",
            "middle_name": "D.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.