Active NPI
Thomas Charles Melillo, DPM
- Foot & Ankle Surgery Podiatrist
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- DP00334
- Practice address
- 9115 SW Oleson Rd Ste 205
Portland, OR 97223-6877 - Phone
- (503) 245-2420
- NPI assigned
- Aug 29, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | DP00334 | OR | Primary |
Addresses
Primary practice location
9115 SW Oleson Rd Ste 205
Portland, OR 97223-6877
Mailing address
9115 SW Oleson Rd Ste 205
Portland, OR 97223-6877
Phone (503) 245-2420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228835 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Kent State University College of Podiatric Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9115 SW Oleson Rd
Suite 205
Portland, OR 97223-6877
Phone (503) 245-2420
Hospital & facility affiliations
- Providence St Vincent Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 65 |
| Removal of nail tissue | 202 |
| Removal or shaving of skin growth | 179 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Extremity Specialists LLC | Current | Accepting new patients | |
| Northwest Extremity Specialists LLC | Current | Accepting new patients |
Locations
16144 SE Happy Vly Twn Center Dr
Ste 101
Happy Valley, OR 97086
Phone (503) 353-1272
201 N Washington St
Newberg, OR 97132
Phone (503) 538-0800
6542 SE Lake Rd
Ste 102
Portland, OR 97222
Phone (503) 659-6686
1515 NW 18th Ave
Ste 300
Portland, OR 97209
16770 SW Edy Rd
Ste 216
Sherwood, OR 97140
Phone (503) 297-3778
9900 SW Hall Blvd
Ste 100
Tigard, OR 97223
9115 SW Oleson Rd
Ste 205
Tigard, OR 97223
Phone (503) 243-5710
9115 SW Olson Rd
Tigard, OR 97223
Phone (971) 236-0915
18040 SW Lower Boones Ferry Rd
Ste 207
Tigard, OR 97224
Phone (503) 216-5380
5493 Amy St
West Linn, OR 97068
Phone (503) 710-9839
Interoperability endpoints
- thomas.melillo@pfac.eclinicaldirectplus.com
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.
-
- Podiatrist
- Portland, OR
- NPI 1295126241
-
- Podiatric Clinic/Center
- Wilsonville, OR
- NPI 1346973039
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1619085479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9115 SW OLESON RD STE 205",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972236877",
"telephone_number": "503-245-2420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9115 SW OLESON RD STE 205",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972236877",
"telephone_number": "503-245-2420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELILLO",
"first_name": "THOMAS",
"middle_name": "CHARLES",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OR",
"license": "DP00334",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "228835",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.