Individual provider Active NPI

Martha Lilia Melendez, MD

  • Family Medicine Physician
  • Colton, CA
National Provider Identifier
1992710396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A64831 Issued in CA
Practice address
400 N Pepper Ave
Arrowhead Regional Medical Center
Colton, CA 92324-1819
Phone
(909) 580-6240
Fax
(909) 580-6308
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A64831 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Arrowhead Regional Medical Center
Colton, CA 92324-1819

Mailing address

PO Box 5157
San Bernardino, CA 92412-5157
Phone (909) 580-6240

Other identifiers 1

IdentifierTypeStateIssuer
00A648310MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081117000716 CA Practitioner - Family Practice 1759441090 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64831CAMDDentist
A64831CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Family Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
County of San Bernardino Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 7, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jul 7, 2019 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

30420 Haun Rd
Menifee, CA 92584

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992710396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5157",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924125157",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "ARROWHEAD REGIONAL MEDICAL CENTER",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "MARTHA",
        "middle_name": "LILIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A648310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.