| Dr Grace M Sally Mellgren, MD | |
|
342 Sherrill Ln, Roswell, NM 88201-5819 | |
| (575) 625-0123 | |
| (575) 625-0131 |
| Full Name | Dr Grace M Sally Mellgren |
|---|---|
| Gender | Female |
| Speciality | Ophthalmology |
| Experience | 42 Years |
| Location | 342 Sherrill Ln, Roswell, New Mexico |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184709339 | NPI | - | NPPES |
| ZZZ07175Z | Other | CA | BLUE SHIELD OF CA |
| 00G53480 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | MD2015-0927 (New Mexico) | Primary |
| 207W00000X | Ophthalmology | G53485 (California) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lovelace Regional Hospital - Roswell | Roswell, NM | Hospital |
| Roosevelt General Hospital | Portales, NM | Hospital |
| Nor-lea Hospital District | Lovington, NM | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Engstrom Eye Center Llc | 4385716729 | 2 |
| Pacific Cataract And Laser Institute Inc Pc | 7517864119 | 76 |
| Entity Name | Engstrom Eye Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013187798 PECOS PAC ID: 4385716729 Enrollment ID: O20080701000044 |
| Entity Name | Pacific Cataract And Laser Institute Inc Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194970418 PECOS PAC ID: 7517864119 Enrollment ID: O20090513000079 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Grace M Sally Mellgren, MD 342 Sherrill Ln, Roswell, NM 88201-5819 Ph: (575) 625-0123 | Dr Grace M Sally Mellgren, MD 342 Sherrill Ln, Roswell, NM 88201-5819 Ph: (575) 625-0123 |
Dr. Paul F Engstrom, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 342 Sherrill Ln, Roswell, NM 88201 Phone: 575-625-0123 Fax: 575-625-0131 | |
Dr. Richard J Sidd, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 207 N Union Ave Ste C, Roswell, NM 88201 Phone: 575-622-7295 Fax: 575-622-7295 | |
Stephen W Montgomery, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 101 N Missouri Avenue, Roswell, NM 88203 Phone: 505-623-8420 |