Individual provider Active NPI

Marcio Melo, NP

  • Family Nurse Practitioner
  • Watsonville, CA
National Provider Identifier
1790321164
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95012400 Issued in CA
Practice address
1430 Freedom Blvd Ste D
Watsonville, CA 95076-2752
Phone
(831) 763-8400
NPI assigned
Nov 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95012400 CA Primary

Addresses

Primary practice location

1430 Freedom Blvd Ste D
Watsonville, CA 95076-2752

Mailing address

1430 Freedom Blvd Ste D
Watsonville, CA 95076-2752

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200310000356 CA Practitioner - Nurse Practitioner 1254769060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone (831) 454-5401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95012400CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz CurrentSince Jan 13, 2020 Accepting new patients
County of Santa Cruz CurrentSince Jan 13, 2020 Accepting new patients

Locations

1080 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4100

1430 Freedom Blvd
Ste D
Watsonville, CA 95076
Phone (831) 763-8400

1430 Freedom Blvd
Watsonville, CA 95076
Phone (831) 763-8200

1430 Freedom Blvd
Ste B
Watsonville, CA 95076
Phone (831) 359-5653

Interoperability endpoints

  • Direct secure messaging: mmelo297475@direct.ochin.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1790321164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD STE D",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD STE D",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762752",
            "telephone_number": "831-763-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELO",
        "first_name": "MARCIO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.