MICHAEL W MELLON (PHD) – Clinical Psychologist, NPI 1023088804

MICHAEL W MELLON (PHD) is a healthcare provider. based in Cincinnati, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 6611 (OH). The NPI Number for MICHAEL W MELLON (PHD) is 1023088804

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL W MELLON (PHD)
NPI
1023088804
Phone
(513) 636-4336
Address
3333 BURNET AVENUE
Enumeration Date
25 January 2006
Last Update Date
31 March 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5136364200
Graduation Year
1993 (33 years ago)
PAC ID
7911055173
Group Practice PAC ID
8426955733
Professional Enrollment ID
I20100609000195
Address ID
OH452293026CI3333XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for MICHAEL W MELLON (PHD)

  • Cincinnati Children’s Hospital Medical Center, 3333, Burnet Avenue, Pill Hill, Corryville, Cincinnati, Hamilton County, Ohio, 45229-3026, United States

    ML 3015

    CINCINNATI, OH 452293039

    Phone: (513) 636-4336

    Fax: (513) 636-3677

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100609000195IClinical PsychologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45229)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426955733View full group profile

Reviews

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Frequently asked questions

Where can patients find MICHAEL W MELLON (PHD)'s NPI?
You can confirm MICHAEL W MELLON (PHD) with NPI 1023088804; it appears in the national provider directory.
Is MICHAEL W MELLON (PHD) active in the national directory?
MICHAEL W MELLON (PHD)'s public NPI profile is in an active state.
What does MICHAEL W MELLON (PHD) treat or focus on?
Patients typically see MICHAEL W MELLON (PHD) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does MICHAEL W MELLON (PHD) practice in Ohio?
You will see Cincinnati, Ohio on file for MICHAEL W MELLON (PHD) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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