Michael George Mellis, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

0101042579 Issued in VA

Practice address

1860 Town Center Dr
Suite 225
Reston, VA 20190-5896

Phone

(703) 483-3610

Fax

(703) 483-3610

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: michael.mellis@lmg1.eclinicaldirectplus.com

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262995200000",
    "number": "1720052178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR",
            "address_2": "SUITE 225",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905896",
            "telephone_number": "703-483-3610",
            "fax_number": "703-483-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLIS",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2010-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101042579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00350018",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mehr Home Care Agency, LLC
• Sahar N/a Mehrzad
• Yash Mehta, D.O.
• Jacquelyn Schaefer Meinhardt, DNP, MSHS, FNP-BC
• Katherine Mejia Sanchez
• Rebecca Milloy Mello, LCSW
• Seth Nathaniel Meltzer, M.D.
• Bhavisha Menezes, M.D.
• Jonathan Bernard Menezes, M.D.
• John Alphonse Mercantini, DMD

• Otolaryngology Physician in Reston, VA
• Providers in Reston, VA by specialty
• Otolaryngology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.