NPIMap

Individual provider Active NPI

Elisa Guardiola Melendez, MD

  • Family Medicine Physician
  • Thornton, CO
National Provider Identifier
1962523555
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46156 Issued in CO
Practice address
1181 E. 120TH Ave, Unit a
Thornton, CO 80233
Phone
(303) 673-1500
Fax
(303) 689-6664
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46156 CO Primary

Addresses

Primary practice location

1181 E. 120TH Ave, Unit a
Thornton, CO 80233

Mailing address

5075 Lincoln St
Denver, CO 80216-2015
Phone (303) 458-5302

Other identifiers 1

IdentifierTypeStateIssuer
03929001MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071207000855 CO Practitioner - Family Practice 1052400447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

1181 E 120TH Ave Unit a
Thornton Clinic
Thornton, CO 80233-5729
Phone (303) 673-1500

2152 E 88TH Ave
Thornton, CO 80229-5023
Phone (303) 227-0400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46156COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 1, 2017 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 1, 2017 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients

Locations

500 Eldorado Blvd
Ste 6250
Broomfield, CO 80021
Phone (303) 272-0750

1181 E 120th Ave
Thornton, CO 80233

1181 E 120th Ave
Unit A
Thornton, CO 80233
Phone (303) 673-1500

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
La Clinica Tepeyac, IncDenver, CO, CCN 061047 Federally qualified health center Other Aug 15, 2015

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 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.

Hospital & facility affiliations 12

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1962523555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 LINCOLN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802162015",
            "telephone_number": "303-458-5302",
            "fax_number": "303-433-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 E. 120TH AVE, UNIT A",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80233",
            "telephone_number": "303-673-1500",
            "fax_number": "303-689-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "ELISA",
        "middle_name": "GUARDIOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "46156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03929001",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.