Individual provider Active NPI

Christopher R Mellon, DO

  • Trauma Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1669835823
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
009570 Issued in AZ
Practice address
16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Phone
(602) 996-4747
Fax
(602) 953-5466
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 009570 AZ
Surgical Critical Care Physician 2086S0102X 009570 AZ
Trauma Surgery Physician 2086S0127X 009570 AZ Primary

Addresses

Primary practice location

16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356

Mailing address

16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Phone (602) 996-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220810002958 AZ Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 9436532397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Arizona College of Osteopathic Medicine Mid Western University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgical Specialists LLCGroup PAC ID 7315106416, 17 clinicians

Practice addresses (Care Compare)

16601 N 40TH St
Suite 204
Phoenix, AZ 85032-3356
Phone (602) 633-3721

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Surgical Clinics, LTD Surgery CurrentSince Jul 1, 2024 Accepting new patients
Acute Care Surgical Specialists, LLC CurrentSince Aug 1, 2022 Accepting new patients
Honorhealth Past Accepting new patients
SMSJ Tucson Holdings LLC Past Accepting new patients

Locations

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

16601 N 40th St
Ste 204
Phoenix, AZ 85032
Phone (602) 633-3721

6036 N 19th Ave
Ste 208
Phoenix, AZ 85015
Phone (480) 896-9888

10290 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 905-2015

Interoperability endpoints

  • Direct secure messaging: christophermellon@vsc.allscriptsdirect.net

Organizations & group practices 4

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 3

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1669835823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLON",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "009570",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "009570",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "009570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.