Individual provider Active NPI

Melia Hernandez Holt, M.D.

  • Dermatology Physician
  • Longwood, FL
National Provider Identifier
1902284177
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME139164 Issued in FL
Practice address
515 W State Road 434 Ste 210
Longwood, FL 32750-5162
Phone
(407) 332-8080
Fax
(407) 260-0602
NPI assigned
May 8, 2015
Last updated
Jul 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X ME139164 FL Primary

Addresses

Primary practice location

515 W State Road 434 Ste 210
Longwood, FL 32750-5162

Mailing address

515 W State Road 434 Ste 210
Longwood, FL 32750-5162
Phone (407) 332-8080

Other practice location 1

300 E Hazel St
Orlando, FL 32804-4023
Phone (407) 898-3033

Other practice location 2

2850 Morningside Dr
Mount Dora, FL 32757-6610
Phone (352) 383-0733

Other names 1

  • Melia Dorothy Hernandez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190808001010 FL Practitioner - Dermatology 0749580553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group PAGroup PAC ID 4385676782, 11 clinicians

Practice addresses (Care Compare)

2850 Morningside Dr
Mount Dora, FL 32757-6610
Phone (352) 383-0733

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision81
Removal of skin lesions1751
Removal or shaving of skin growth167
Skin biopsy877

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group PA Single Specialty CurrentSince Aug 12, 2019 Accepting new patients
Steven M. Price, MD PA Single Specialty PastSince Mar 10, 2010 Accepting new patients
Jewett Orthopaedic Clinic LLC Single Specialty PastSince Jul 25, 2019 Accepting new patients

Locations

515 W State Road 434
Ste 210
Longwood, FL 32750
Phone (407) 332-8080

2850 Morningside Dr
Mount Dora, FL 32757
Phone (352) 383-0733

300 E Hazel St
Orlando, FL 32804
Phone (407) 898-3033

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1902284177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434 STE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505162",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434 STE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505162",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E Hazel St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044023",
            "country_code": "US",
            "telephone_number": "407-898-3033",
            "fax_number": "407-898-0739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 Morningside Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Dora",
            "state": "FL",
            "postal_code": "327576610",
            "country_code": "US",
            "telephone_number": "352-383-0733",
            "fax_number": "352-383-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLT",
        "first_name": "MELIA",
        "middle_name": "HERNANDEZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME139164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELIA",
            "last_name": "HERNANDEZ",
            "middle_name": "DOROTHY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.