CHARLES DANIEL MELANCON PA NPI 1619977881

NPI Information

  • NPI: 1619977881
  • Provider Name: CHARLES DANIEL MELANCON, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1103 KALISTE SALOOM ROAD
    SUITE 102
    LAFAYETTE, LA
    ZIP 70508
  • Phone: (337) 234-5234

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NPI Details

Charles Daniel Melancon, PA is a surgical physician assistant in Lafayette, LA with 23 years of experience. Charles Daniel Melancon, PA NPI is 1619977881. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1103 KALISTE SALOOM ROAD
SUITE 102
LAFAYETTE, LA
ZIP 70508-636
Phone: (337) 234-5234
Fax: (337) 235-2121

The NPI 1619977881 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment (HCPCS:63047)
  • Fusion of spine in lower back (HCPCS:22612)

The enumeration date for this NPI number is 7/28/2005 and was last updated on 2/5/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalA10616LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
154977P824MEDICARE PINLOUISIANA
2Q20796MEDICARE UPIN
35DD02P969MEDICARE PINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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