NPIMap

Individual provider Active NPI

Melaina Zanele Blomenkamp, PA-C

  • Medical Physician Assistant
  • Kingman, AZ
National Provider Identifier
1780605048
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2731 Issued in AZ
Practice address
3269 Stockton Hill Rd
Kingman, AZ 86409-3619
Phone
(928) 757-2101
NPI assigned
Jul 22, 2006
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2731 AZ Primary

Addresses

Primary practice location

3269 Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

410 Brite Dr
Lake Havasu City, AZ 86406-7088
Phone (928) 854-2542

Other names 1

  • Melaina Zanele Lella Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050822000048 AZ Practitioner - Physician Assistant 5092745810 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Coast Ear, Nose and Throat, LTD.Group PAC ID 2668456104, 5 clinicians
HRMC, LLCGroup PAC ID 3072641265, 33 clinicians

Practice addresses (Care Compare)

1760 McCulloch Blvd N
Suite 100
Lake Havasu City, AZ 86403-6559

1760 McCulloch Blvd N
Suite 100
Lake Havasu City, AZ 86403-6978
Phone (928) 854-8368

1760 N McCulloch Blvd
Suite 100
Lake Havasu City, AZ 86403-6559
Phone (928) 854-5368

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HRMC, LLC CurrentSince Mar 1, 2026 Accepting new patients
HRMC, LLC Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
HRMC, LLC Past Accepting new patients
Nextcare Arizona I JV LLC Past Accepting new patients
Burt Faibisoff, MD, PLLC Past Accepting new patients
HRMC, LLC Physician Assistant Past Accepting new patients
Twin Peaks Medical Associates PLLC Past Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1760 McCulloch Blvd N
Ste 100
Lk Havasu Cty, AZ 86403
Phone (928) 854-5368

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1780605048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 BRITE DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864067088",
            "telephone_number": "928-854-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMENKAMP",
        "first_name": "MELAINA",
        "middle_name": "ZANELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELAINA",
            "last_name": "LELLA",
            "middle_name": "ZANELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.