Theodore Mello

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 39711 Issued in CA

Practice address

145 Shaw Ave
Suite a
Clovis, CA 93612-3841

Phone

(559) 299-2244

NPI assigned

Dec 5, 2012

Sex

Male

Sole proprietor

No

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hughes/Brogan Physical TherapyGroup PAC ID 6507754884, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Cornerstone Physical Therapy

  • Physical Therapist
  • Fresno, CA
  • NPI 1528100450
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1861737629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8059 N 8TH ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SHAW AVE",
            "address_2": "SUITE A",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123841",
            "telephone_number": "559-299-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "THEODORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 39711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nishit Jatinbhai Mehta, DDS
• Pooja Mehta, DMD
• Alexis Sarah Mejia, PHARM.D.
• Tiffiny Jessica Torres Mejia
• Sergio J. Melara Mojica, DPM
• Stephanie Danyell Melton, RN
• Carol Ann Meme, RD
• Rebecca Marissa Mena, FNP
• Susan Diane Mencarini, OD
• Angelica Mendez

• Physical Therapist in Clovis, CA
• Providers in Clovis, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.