Active NPI
Melissa Anne De la O, AU.D.
- Audiologist
- Monroe, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 8159
- Practice address
- 2516 Broadmoor Blvd # 1B
Monroe, LA 71201 - Phone
- (318) 812-1125
- NPI assigned
- May 25, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 8159 | LA | Primary |
| Audiologist | 231H00000X |
Addresses
Primary practice location
2516 Broadmoor Blvd # 1B
Monroe, LA 71201
Mailing address
130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 807-7875
Other practice location 1
2516 Broadmoor Blvd # 1B
Monroe, LA 71201
Phone (318) 812-1125
Other practice location 2
2516 Broadmoor Blvd # 1B
Monroe, LA 71201
Phone (318) 812-1125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2478877 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 81.51 of 100
- Quality
- 60.04
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8159 | LA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Health Group, LLC | Current | Accepting new patients | |
| Affinity Health Group, LLC | Current | Accepting new patients | |
| Baton Rouge Clinic, a Medical Corporation | Current | Accepting new patients | |
| Affinity Health Group, LLC | Current | Accepting new patients | |
| Baton Rouge Clinic, a Medical Corporation | Current | Accepting new patients |
Locations
7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790
130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875
2516 Broadmoor Blvd
#1B
Monroe, LA 71201
Phone (318) 812-1125
2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Monroe, LA
- NPI 1023291226
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1871546911
-
- Family Medicine Physician
- Monroe, LA
- NPI 1184791287
-
- Orthopaedic Surgery Physician
- Monroe, LA
- NPI 1861879249
-
- Ophthalmology Physician
- Baton Rouge, LA
- NPI 1528941655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1699266643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DESIARD ST STE 355",
"city": "MONROE",
"state": "LA",
"postal_code": "712017363",
"telephone_number": "318-807-7875",
"fax_number": "318-812-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2516 BROADMOOR BLVD # 1B",
"city": "MONROE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "318-812-1125"
}
],
"practiceLocations": [
{
"address_1": "2516 Broadmoor Blvd # 1B",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "LA",
"postal_code": "71201",
"country_code": "US",
"telephone_number": "318-812-1125",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2516 Broadmoor Blvd # 1B",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "LA",
"postal_code": "71201",
"country_code": "US",
"telephone_number": "318-812-1125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE LA O",
"first_name": "MELISSA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "LA",
"license": "8159",
"primary": true
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2478877",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.