Maxwell Franklin Mello, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11286 Issued in TX

Practice address

3000 N Ih 35 Ste 700
Austin, TX 78705-1852

Phone

(512) 807-3150

Fax

(512) 458-7879

NPI assigned

May 2, 2017

Last updated

Apr 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: 428-mello-maxwell@direct.leadingreach.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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• Emergency Associates of Central Texas PA

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  Medicare reassignment
• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
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  Medicare reassignment
• St. David's Ortho, Neuro and Rehab, PLLC

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1669742755
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1710413349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N IH 35 STE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051852",
            "telephone_number": "512-807-3150",
            "fax_number": "512-458-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N IH 35 STE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051852",
            "telephone_number": "512-807-3150",
            "fax_number": "512-458-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "MAXWELL",
        "middle_name": "FRANKLIN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11286",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA11286",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3729931-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "577715YRMQ",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmello86612@epiccwdv.hcadirect.net",
            "affiliation": "N",
            "address_1": "3000 N Ih 35 Ste 700",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787051852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Peterson Fleming (Melissa Fleming, LPC)
• Melissa Winn MD, PA
• Tandy Alice Mellard, PNP
• Julie Elise Mellin, APRN, PMHNP-BC
• Leah Mello, M.D.
• Linda Melnick, LCSW
• Larisa V Melnikova, PTA
• Katherine Melo Li, PSYCHOLOGIST
• Evan Melrose, MD
• Jennifer Vane Melrose, PH.D.

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.

Verify at the official NPI Registry.