NPIMap

Individual provider Active NPI

Richard J Mellitt, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Columbia, MO
National Provider Identifier
1730171026
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2000168805 Issued in MO
Practice address
1605 E Broadway Ste 210
Columbia, MO 65201-8023
Phone
(573) 815-4130
Fax
(573) 815-4135
NPI assigned
Aug 22, 2005
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2000168805 MO Primary

Addresses

Primary practice location

1605 E Broadway Ste 210
Columbia, MO 65201-8023

Mailing address

1605 E Broadway Ste 210
Columbia, MO 65201-8023
Phone (573) 815-4130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100109000281 MO Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 4385785542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
Saint Louis University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000168805MOMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chas Physician Services, LLC CurrentSince Nov 1, 2009 Accepting new patients
Chas Physician Services LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Nov 1, 2009 Accepting new patients
Boone Physician Services, LLC CurrentSince Apr 1, 2021 Accepting new patients
Missouri Cardiovascular Specialists Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
CH Allied Services, Inc. Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1605 E Broadway
Ste 210
Columbia, MO 65201
Phone (573) 815-2236

1605 E Broadway
Ste 300
Columbia, MO 65201
Phone (573) 256-7700

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/gemms-mis01
  • Direct secure messaging: richardmellitt@mhccaremail.com

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1730171026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 E BROADWAY STE 210",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018023",
            "telephone_number": "573-815-4130",
            "fax_number": "573-815-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E BROADWAY STE 210",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018023",
            "telephone_number": "573-815-4130",
            "fax_number": "573-815-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLITT",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2000168805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.