Angelica Melillo Knickerbocker, MD, MPH

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

S4798 Issued in TX

Practice address

1330 N Beckley Ave
Dallas, TX 75203-1271

Phone

(214) 941-7200

NPI assigned

Mar 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Angelica Bianca Melillo Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.87 of 100Reported as group

Quality

70.15

Promoting interoperability

100

Improvement activities

40

Cost

72.75

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment Care Compare group NPD
• Kessler Womens Healthcare PA

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1760642581
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1710959135
  NPD
• University of Texas Southwestern Medical Center at Dallas

  dba UT Southwestern University Hospital

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1285798918
  NPD (past)
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1790148591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE 36TH ST APT 1409",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373938",
            "telephone_number": "347-880-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031271",
            "telephone_number": "214-941-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "ANGELICA",
        "middle_name": "MELILLO",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "S4798",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "MELILLO",
            "middle_name": "BIANCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Ann Knesevich, M.D.
• Emily Brown Knez, M.D.
• Barry Keith Knezek, M.D.
• KNH Dentistry PC (Kirk N Hampton DDS)
• Allie Gammill Knicely, FNP
• Chase Knickerbocker, M.D.
• Wendy Kniffen, PA-C
• Delbert Henry Knight Sr.
• John Thomas Knight, MD
• Kathryn Knight

• Obstetrics & Gynecology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.