Northwest Extremity Specialists, LLC
Podiatry practice in Portland, OR
Registered providerLicense # listed (OR)Medicare-enrolled groupAccepts Medicare assignment
Public-record details
- Address
- 9115 Sw Oleson Rd Ste 205, Portland, OR 97223
- Phone
- (503) 245-2420
- Listed under
- Practices and organizations, Foot and ankle surgery (registered), Telehealth (Medicare claims)
- NPI
- 1336511435
- NPI status
- Active in the NPPES registry
- Provider type
- Organization (practice, clinic or company)
- Registered specialty (self-reported taxonomy)
- Podiatrist, Foot & Ankle Surgery (213ES0103X)
- License number on NPI record
- DP00330 (OR)
- Authorized official
- Thomas Melillo, DPM, Owner
- NPI first issued
- Oct 28, 2015
- Years since NPI first issued
- 11 years (since 2015)
- License state on NPI record
- OR
- NPI record last updated
- Jan 6, 2021
- Medicare group enrollment (CMS)
- Enrolled: listed in CMS Doctors & Clinicians as Northwest Extremity Specialists LLC
- Clinicians in the Medicare group (all specialties, CMS)
- 21
- Podiatrists in the group at this ZIP (CMS)
- 12
- Group Medicare assignment (CMS)
- Accepts the Medicare-approved amount as payment in full
- Other NPIs for this organization here
- 1295126241
- Other podiatry listings at this street address
- 3
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