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Individual provider Active NPI

Violeta Tammy De la Melena, M.D.

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1568492767
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD23822 Issued in OR
Practice address
9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663
Phone
(503) 297-7403
Fax
(503) 297-3096
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD23822 OR Primary

Addresses

Primary practice location

9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663

Mailing address

9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663
Phone (503) 297-7403

Other identifiers 2

IdentifierTypeStateIssuer
1041716MedicaidWA
181464MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100909000688 OR Practitioner - General Surgery 0042367278 Reassigns benefits to 1 organization
I20120611000238 WA Practitioner - General Surgery 0042367278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600

265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23822ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Cancer Specialists, PC CurrentSince Mar 2, 2012 Accepting new patients
Surgical Associats, PC Surgery PastSince Jun 16, 2014 Accepting new patients

Locations

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

Interoperability endpoints

  • Direct secure messaging: tammy.de.la.melena@compass.ikm.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1568492767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-297-7403",
            "fax_number": "503-297-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-297-7403",
            "fax_number": "503-297-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA MELENA",
        "first_name": "VIOLETA",
        "middle_name": "TAMMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD23822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041716",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181464",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.