Active NPI
Michael S Melton, MD
- Family Medicine Physician
- Bend, OR
National Provider Identifier
1609850775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD201470
- Practice address
- 61250 SE Coombs PL
Bend, OR 97702-3704 - Phone
- (541) 706-5930
- Fax
- (541) 706-5931
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME90790 | FL | |
| Family Medicine Physician | 207Q00000X | MD201470 | OR | Primary |
Addresses
Primary practice location
61250 SE Coombs PL
Bend, OR 97702-3704
Mailing address
2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321
Other practice location 1
2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321
Other practice location 2
1781 Park Center Dr
Su 120
Orlando, FL 32835-6254
Phone (407) 297-3626
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7159625 | Other | FL | AETNA |
| 9227094002 | Other | FL | CIGNA |
| 48499 | Other | FL | BLUE CROSS BLUE SHIELD |
| P00185798 | Other | FL | RAILROAD MEDICARE |
| 244227 | Other | FL | WELLCARE |
| 270432300 | Medicaid | FL | |
| 3570709 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD201470 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Healthcare, Inc. | Family Medicine | Past | Accepting new patients |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664496000000",
"number": "1609850775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 NE NEFF RD",
"city": "BEND",
"state": "OR",
"postal_code": "977016015",
"telephone_number": "541-382-4321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61250 SE COOMBS PL",
"city": "BEND",
"state": "OR",
"postal_code": "977023704",
"telephone_number": "541-706-5930",
"fax_number": "541-706-5931"
}
],
"practiceLocations": [
{
"address_1": "2500 NE Neff Rd",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977016015",
"country_code": "US",
"telephone_number": "541-382-4321",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1781 Park Center Dr",
"address_2": "SU 120",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328356254",
"country_code": "US",
"telephone_number": "407-297-3626",
"fax_number": "407-297-3772",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MELTON",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2022-09-30",
"certification_date": "2022-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME90790",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD201470",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7159625",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9227094002",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "48499",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00185798",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "244227",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270432300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3570709",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.