Individual provider Active NPI

Carlos A Mella-Picel, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1770713125
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036.130535 Issued in IL
Practice address
4959 W Belmont Ave Ste N
Chicago, IL 60641-4332
Phone
(773) 930-3642
Fax
(773) 930-3974
NPI assigned
Jul 20, 2009
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.056702 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036.130535 IL Primary

Addresses

Primary practice location

4959 W Belmont Ave Ste N
Chicago, IL 60641-4332

Mailing address

4959 W Belmont Ave Ste N
Chicago, IL 60641-4332
Phone (773) 930-3649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260605001009 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2264673268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2217 N Lincoln Ave
Chicago, IL 60614-3717
Phone (773) 248-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.056702ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Direction Medical Center, S.C. Internal Medicine CurrentSince Jun 22, 2021 Accepting new patients
Novalife Medical, PLLC Geriatric Medicine Current Accepting new patients
Juan F Zapata, M.D. LLC Internal Medicine PastSince Jun 22, 2021 Accepting new patients

Locations

2217 N Lincoln Ave
Chicago, IL 60614
Phone (312) 416-0902

4959 W Belmont Ave
Chicago, IL 60641
Phone (773) 237-1122

4959 W Belmont Ave
Ste N
Chicago, IL 60641
Phone (773) 622-4400

Interoperability endpoints

  • Direct secure messaging: cmellapicel284234@direct.myadvocateaurora.org

Organizations & group practices 3

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 1

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1770713125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 W BELMONT AVE STE N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414332",
            "telephone_number": "773-930-3649",
            "fax_number": "773-930-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 W BELMONT AVE STE N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414332",
            "telephone_number": "773-930-3642",
            "fax_number": "773-930-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLA-PICEL",
        "first_name": "CARLOS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.056702",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036.130535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.