Individual provider Active NPI

Matthew William Mell, M.D., F.A.C.S.

  • Vascular Surgery Physician
  • Stanford, CA
National Provider Identifier
1730132978
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G065758 Issued in CA
Practice address
300 Pasteur Drive, H3600
Stanford University Hospital and Clinics
Stanford, CA 94305-5642
Phone
(650) 723-3639
Fax
(650) 498-6044
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X G065758 CA Primary

Addresses

Primary practice location

300 Pasteur Drive, H3600
Stanford University Hospital and Clinics
Stanford, CA 94305-5642

Mailing address

300 Pasteur Drive, H3600
Stanford University Hospital and Clinics
Stanford, CA 94305-5642
Phone (650) 723-3639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20091106000572 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 3577567833 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65758CAMDPharmacist
G065758CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jun 1, 2016 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 14, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
County of Santa Clara CurrentSince Jun 1, 2016 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 14, 2018 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Stanford Health Care Past Accepting new patients
LPCH Medical Group Div of Lucile Past Accepting new patients

Locations

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

450 Broadway St
Fl 2
Redwood City, CA 94063
Phone (650) 498-3931

4860 Y St
Ste 2100
Sacramento, CA 95817
Phone (916) 734-3800

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

300 Pasteur Dr
#H3600
Stanford, CA 94305
Phone (650) 723-3639

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1730132978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DRIVE, H3600",
            "address_2": "STANFORD UNIVERSITY HOSPITAL AND CLINICS",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055642",
            "telephone_number": "650-723-3639",
            "fax_number": "650-498-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DRIVE, H3600",
            "address_2": "STANFORD UNIVERSITY HOSPITAL AND CLINICS",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055642",
            "telephone_number": "650-723-3639",
            "fax_number": "650-498-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELL",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G065758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.