Individual provider Active NPI

Melecio G Abordo Jr., M.D.

  • Internal Medicine Physician
  • Jackson, KY
National Provider Identifier
1871590935
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34645 Issued in KY
Practice address
12 Jackson HTS
Jackson, KY 41339-6500
Phone
(606) 693-0199
Fax
(606) 666-9480
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34645 KY Primary
Cardiovascular Disease Physician 207RC0000X 34645 KY

Addresses

Primary practice location

12 Jackson HTS
Jackson, KY 41339-6500

Mailing address

12 Jackson HTS
Jackson, KY 41339-6500
Phone (606) 693-0199

Other identifiers 1

IdentifierTypeStateIssuer
64364458MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20040202000139 KY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3375445745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical Specialty Clinic PLLC 2 clinicians
Ambulatory Care Services PLLC 4 clinicians

Practice addresses (Care Compare)

12 Jackson HTS
Jackson, KY 41339-6500
Phone (606) 693-0199

31 Main St
Campton, KY 41301-9750
Phone (606) 668-9076

Hospital & facility affiliations

  • Kentucky River Medical Center Hospital, Jackson, KY, CCN 181334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34645KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Specialty Clinic PLLC Internal Medicine CurrentSince Jan 1, 2004 Accepting new patients
Ambulatory Care Services PLLC Internal Medicine CurrentSince Apr 12, 2004 Accepting new patients
QPS LLC Past Accepting new patients
Iraklis C Livas MD PSC Past Accepting new patients
Jackson Hospital Corporation Past Accepting new patients

Locations

31 Main St
Campton, KY 41301
Phone (606) 668-9076

12 Jackson Hts
Jackson, KY 41339
Phone (606) 693-0199

540 Jett Dr
Jackson, KY 41339
Phone (606) 666-4971

95 Jackson Hts
Jackson, KY 41339
Phone (606) 666-7040

1550 Highway 15 S
#28
Jackson, KY 41339
Phone (606) 693-0199

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ambulatory Care Services PLLCCampton, KY, CCN B03856 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer
Operational/Managerial Control
Apr 12, 2004
Apr 12, 2004
Apr 12, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 1

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1871590935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JACKSON HTS",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413396500",
            "telephone_number": "606-693-0199",
            "fax_number": "606-666-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JACKSON HTS",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413396500",
            "telephone_number": "606-693-0199",
            "fax_number": "606-666-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABORDO",
        "first_name": "MELECIO",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34645",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "34645",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64364458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, KY

Sources for this page

Verify at the official NPI Registry.