Melissa M. M. Agoudemos
M.D. | Pediatric Cardiology | Female
Melissa M. M. Agoudemos, M.D. is a Meridian, Idaho based Pediatric doctor with medical specialization in
Pediatric Cardiology.
Current practice location of Melissa M. M. Agoudemos is
520 S Eagle Rd, Suite 2204, Meridian, Idaho - 83642-6351. She can be contacted on phone at
208-336-9188 and fax number 208-336-2636.
Melissa M. M. Agoudemos is a sole proprietor of her business.
NPI number (Unique professional ID) for Melissa M. M. Agoudemos is
1518175579 which was assigned by NPPES on 21 May, 2007 and it was last updated on 18 Apr, 2017.
Melissa M. M. Agoudemos license number is
036-125447 for Pediatrics Pediatric Cardiology (2080P0202X) in Illinois.
Melissa M. M. Agoudemos provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Complete Profile:
Melissa M. M. Agoudemos basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Cardiology |
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| Provider Name : | Melissa M. M. Agoudemos |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Melissa M. M. Agoudemos address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 520 S Eagle Rd, Suite 2204
Meridian, ID, 83642-6351
United States |
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| Phone Number : | 208-336-9188 |
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| Fax Number : | 208-336-2636 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1518175579 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 21 May, 2007 |
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| Last Updated On : | 18 Apr, 2017 |
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Medicare Participation:
Melissa M. M. Agoudemos participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 1456547447 |
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| Medicare Enrollment ID : | I20160718002095 |
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| Primary Specialty : | Cardiovascular Disease (cardiology) |
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| Medical School : | Medical College Of Wisconsin |
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| Graduation Year : | 2004 |
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| Accepts Medicare? | Yes. Melissa M. M. Agoudemos accepts medicare insurance. |
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Group Practice Association:
Melissa M. M. Agoudemos is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Melissa M. M. Agoudemos is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| St Lukes Clinic - Treasure Valley Llc | 4981878402 | 884 | 520 S Eagle Rd
Suite 2104
Meridian, ID - 836426363
Ph: 2087060201 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Melissa M. M. Agoudemos are as mentioned. Primary taxonomy code for Melissa M. M. Agoudemos, M.D. is
2080P0202X (Pediatrics Pediatric Cardiology).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0202X | Pediatrics Pediatric Cardiology | Yes | 036-125447 | IL |
| 208000000X | Pediatrics | No | R-8001 | IA |
Legacy Identifiers:
Other legacy medical identifiers of Melissa M. M. Agoudemos such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 036125447 | MEDICAID | IL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 520 S Eagle Rd, Suite 2204
Meridian, ID, 83642-6351
United States |
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| Phone Number : | 208-336-9188 |
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| Fax Number : | 208-336-2636 |
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Business Location:
Patients can refer following map for directions to
Melissa M. M. Agoudemos practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.