Active NPI
Joseph Melillo, O.D.
- Optometrist
- El Monte, CA
National Provider Identifier
1952350654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4191T
- Practice address
- 11100 Valley Blvd
108
El Monte, CA 91731-2500 - Phone
- (626) 444-2575
- Fax
- (626) 444-2570
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4191T | CA | Primary |
Addresses
Primary practice location
11100 Valley Blvd
108
El Monte, CA 91731-2500
Mailing address
11100 Valley Blvd
108
El Monte, CA 91731-2500
Phone (626) 444-2575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0041910 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4191T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Gabriel Valley Audiology and Hearing AIDS | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Audiologist-Hearing Aid Fitter
- West Covina, CA
- NPI 1003509001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1952350654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11100 VALLEY BLVD",
"address_2": "108",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917312500",
"telephone_number": "626-444-2575",
"fax_number": "626-444-2570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 VALLEY BLVD",
"address_2": "108",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917312500",
"telephone_number": "626-444-2575",
"fax_number": "626-444-2570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELILLO",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4191T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0041910",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Monte, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.