Individual provider Active NPI

Mark D Mellinger, MD

  • Orthopaedic Hand Surgery Physician
  • Flagstaff, AZ
National Provider Identifier
1922070366
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
31185 Issued in AZ
Practice address
1840 N Jasper Dr Ste 2
Flagstaff, AZ 86001-1634
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 31185 AZ
Orthopaedic Surgery Physician 207X00000X 33479 AZ
Orthopaedic Hand Surgery Physician 207XS0106X 33479 AZ
Orthopaedic Surgery Physician 207X00000X 31185 AZ
Orthopaedic Hand Surgery Physician 207XS0106X 31185 AZ Primary

Addresses

Primary practice location

1840 N Jasper Dr Ste 2
Flagstaff, AZ 86001-1634

Mailing address

2208 N Fremont Blvd
Flagstaff, AZ 86001-0957
Phone (928) 774-7757

Other practice location 1

3200 N Windsong Dr
Prescott Valley, AZ 86314-2255
Phone (866) 974-2673

Other practice location 2

4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851
Phone (866) 974-2673

Other practice location 3

18444 N 25th Ave Ste 210
Phoenix, AZ 85023-1264
Phone (866) 974-2676

Other identifiers 1

IdentifierTypeStateIssuer
766446MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040413000815 AZ Practitioner - Orthopedic Surgery 3779577614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Orthopedic Research and Education LLCGroup PAC ID 0345287322, 247 clinicians

Practice addresses (Care Compare)

10494 W Thunderbird Blvd
Sun City, AZ 85351-6122
Phone (866) 974-2673

1840 N Jasper Dr
Flagstaff, AZ 86001-1634
Phone (866) 974-2673

3200 N Windsong Dr
Prescott Valley, AZ 86314-2255
Phone (928) 226-2900

Hospital & facility affiliations

  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062
  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • White Mountain Regional Medical Center Hospital, Springerville, AZ, CCN 031315
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)65
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31185AZMDSpecialist
33479AZMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education LLC CurrentSince Feb 12, 2021 Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery CurrentSince Feb 12, 2021 Accepting new patients
Flagstaff Medical Center Past Accepting new patients

Locations

1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001
Phone (928) 774-7757

1840 N Jasper Dr
Ste 2
Flagstaff, AZ 86001
Phone (928) 226-2900

1840 N Jasper Dr
Ste 3
Flagstaff, AZ 86001

4830 Highway 260
Ste 103
Lakeside, AZ 85929
Phone (928) 532-5227

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738

3200 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 226-2900

95 Soldiers Pass Rd
Ste B1
Sedona, AZ 86336
Phone (928) 204-4900

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

Interoperability endpoints

  • Direct secure messaging: mark.mellinger.1@22724.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1922070366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 N FREMONT BLVD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860010957",
            "telephone_number": "928-774-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N JASPER DR STE 2",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011634",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 N Windsong Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142255",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4830 Highway 260 Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lakeside",
            "state": "AZ",
            "postal_code": "859295851",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18444 N 25th Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850231264",
            "country_code": "US",
            "telephone_number": "866-974-2676",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLINGER",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "31185",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "33479",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "AZ",
            "license": "33479",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "31185",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "AZ",
            "license": "31185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766446",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.