Samantha Jeanne Melillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

255 Lebanon Rd.
Building a, Suite 106
Frisco, TX 75036

Phone

(469) 294-0210

NPI assigned

Jul 11, 2022

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 TN, KS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Carepoint Emergency Medicine Kansas LLC

  • Emergency Medicine Physician
  • Wichita, KS
  • NPI 1477096097
  Medicare reassignment
• Cutting Edge Foot and Ankle Clinic, PLLC

  dba Cutting Edge Foot and Ankle Clinic

  • Podiatric Clinic/Center
  • Nashville, TN
  • NPI 1154889533
  Medicare reassignment
• Music City Foot and Wound Care PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Nashville, TN
  • NPI 1518699461
  Medicare reassignment
• Clover Family Medicine, PLLC

  dba Southern Hospitality by CLOVER FAMILY MEDICINE

  • Family Medicine Physician
  • Frisco, TX
  • NPI 1053992008
  NPD
• Modern Podiatry, LLC

  dba Modern Podiatry: Foot & Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Frisco, TX
  • NPI 1629699798
  NPD
• Footcare USA, PLLC

  • Podiatrist
  • Nashville, TN
  • NPI 1083597116
  NPD (past)

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1831823434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13655 W HIGHLAND SPRINGS CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672358000",
            "telephone_number": "419-779-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LEBANON RD.",
            "address_2": "BUILDING A, SUITE 106",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75036",
            "telephone_number": "469-294-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELILLO",
        "first_name": "SAMANTHA",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John B Meiser, MD
• Jennifer Mejia
• Lena Mekdad, MS, NCC, LPC-INTERN
• Mel Vision LLC (My EyeLab)
• Patricia Melendez, CHW
• Melody of Light Psyhology
• Tara Melton, PT, NCS
• Melvin Hu MD PHD PA (Texas Pain Treatment Center)
• Nicole Marie Mena, MS, LPC
• Erika Debanhi Mendez, DDS

• Physician Assistant in Frisco, TX
• Providers in Frisco, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.