Active NPI
Carl M Melina, MD
- Family Medicine Physician
- Hillsboro, OR
National Provider Identifier
1750448981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD28596
- Practice address
- 18610 NW Cornell Road
Suite 100
Hillsboro, OR 97124-9923 - Phone
- (503) 216-9360
- Fax
- (503) 216-9363
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | M-3948 | ID | |
| Family Medicine Physician | 207Q00000X | MD28596 | OR | Primary |
Addresses
Primary practice location
18610 NW Cornell Road
Suite 100
Hillsboro, OR 97124-9923
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00010004964 | Other | ID | REGENCE BS ID |
| 003843600 | Medicaid | ID | |
| 8167140 | Medicaid | WA | |
| B1725 | Other | ID | BLUE CROSS ID |
| 024599 | Medicaid | OR | |
| 080062808 | Other | ID | RAILRAOD |
| P00650735 | Other | OR | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-3948 | ID | MD | Emergency Medical Services (Emergency Medicine) Physician |
Interoperability endpoints
- cmelina102387@oc.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351382400000",
"number": "1750448981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18610 NW CORNELL ROAD",
"address_2": "SUITE 100",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971249923",
"telephone_number": "503-216-9360",
"fax_number": "503-216-9363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELINA",
"first_name": "CARL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2012-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "ID",
"license": "M-3948",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD28596",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS ID",
"identifier": "00010004964",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003843600",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8167140",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ID",
"identifier": "B1725",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024599",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILRAOD",
"identifier": "080062808",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00650735",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.