Individual provider Active NPI

Carly Melancon, PA-C

  • Physician Assistant
  • New Orleans, LA
National Provider Identifier
1477156586
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
324768 Issued in LA
Practice address
3434 Prytania St Ste 430
New Orleans, LA 70115-3525
Phone
(504) 899-6391
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 324768 LA
Physician Assistant 363A00000X 324768 LA Primary

Addresses

Primary practice location

3434 Prytania St Ste 430
New Orleans, LA 70115-3525

Mailing address

3434 Prytania St Ste 430
New Orleans, LA 70115-3525
Phone (504) 899-6391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210209000344 LA Practitioner - Physician Assistant 5698180412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oano LLCGroup PAC ID 7214294768, 11 clinicians

Practice addresses (Care Compare)

3434 Prytania St
Suite 430
New Orleans, LA 70115-3525
Phone (504) 899-6391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
324768LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oano LLC CurrentSince Nov 23, 2020 Accepting new patients

Locations

3100 Galleria Dr
Ste 300
Metairie, LA 70001
Phone (504) 899-6391

3434 Prytania St
Ste 430
New Orleans, LA 70115
Phone (504) 897-8118

Interoperability endpoints

  • Direct secure messaging: carly.melancon@oano.emadirect.md
  • Direct secure messaging: cmelancon1215751@direct.ochsner.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1477156586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 PRYTANIA ST STE 430",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153525",
            "telephone_number": "504-899-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 PRYTANIA ST STE 430",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153525",
            "telephone_number": "504-899-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELANCON",
        "first_name": "CARLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "324768",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "324768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.