Kristian Andreas Melby, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57172 Issued in CA

Practice address

442 Crocker St
Los Angeles, CA 90013-2115

Phone

(323) 201-4516

NPI assigned

Sep 9, 2016

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Los Angeles Free ClinicGroup PAC ID 5395886311, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• The Los Angeles Free Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1194893248
  Medicare reassignment Care Compare group
• The Los Angeles Free Clinic

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1558740852
  NPD

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1750838413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 CROCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 CROCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132115",
            "telephone_number": "323-201-4516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "442 S San Pedro St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900132132",
            "country_code": "US",
            "telephone_number": "323-201-4516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90014",
            "country_code": "US",
            "telephone_number": "323-201-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELBY",
        "first_name": "KRISTIAN",
        "middle_name": "ANDREAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-09",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leilani Melara
• Leonel Alberto Melara, BS
• Rene Melara, LCSW
• Erica Melbourne, PSYD
• Garrett Denison Melby Jr.
• Eric Melcer, DPT
• Shirin Shahbazi Melchione, D.O.
• Aram Melchor Arana
• Jailene Melchor Leon
• Martha Melchor Salazar

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.