MELINDA MAE MANTOOTH DO
NPI 1639708175
Internal Medicine in Portland, OR
About Melinda Mae Mantooth Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MELINDA MAE MANTOOTH DO (NPI 1639708175) is an individual internal medicine provider in Portland, Oregon, licensed in Oregon (DO217033) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and is a graduate of Pacific Nw Un Of Hs, Col Of Osteopathic Medicine (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Melinda Mae Mantooth Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
6Medicare enrollment records show Melinda Mantooth reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97210
- Reassigned Medicare billing, Oregon enrollment
- 1,248 clinicians in this Medicare group
Vancouver, WA 98686
- Reassigned Medicare billing, Washington enrollment
- 754 clinicians in this Medicare group
Shady Cove, OR 97539
- Reassigned Medicare billing, Oregon enrollment
- Medicare enrollment name: Providence Health & Services Oregon
- 181 clinicians in this Medicare group
Medford, OR 97504
- Reassigned Medicare billing, Oregon enrollment
- 311 clinicians in this Medicare group
Medford, OR 97504
- Reassigned Medicare billing, Oregon enrollment
- 353 clinicians in this Medicare group
Waukegan, IL 60085
- Reassigned Medicare billing, Illinois enrollment
- 166 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Legacy Emanuel Medical Center
Acute Care Hospitals · Portland, ORLegacy Good Samaritan Medical Center
Acute Care Hospitals · Portland, ORProvidence Medford Medical Center
Acute Care Hospitals · Medford, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97227 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97227
PORTLAND, OR 97227
PORTLAND, OR 97227
PORTLAND, OR 97227
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Melinda Mantooth's NPI number?
The NPI number for Melinda Mantooth is 1639708175. It was assigned to this individual provider in the NPPES registry on April 6, 2020.
Where is Melinda Mantooth located?
Melinda Mantooth practices at 2801 N Gantenbein Ave, Portland, OR 97227. The listed phone number is (503) 413-8407.
What is Melinda Mantooth's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Melinda Mantooth enrolled in Medicare?
Yes. Melinda Mantooth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Melinda Mantooth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Melinda Mantooth reassigns Medicare benefits to 6 organizations: Legacy Clinics LLC (Portland, OR), Legacy Salmon Creek Hospital (Vancouver, WA), Sisters Of Providence In Oregon (Shady Cove, OR), Providence Health & Services - Oregon (Medford, OR), Asante Physician Partners (Medford, OR) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Melinda Mantooth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Melinda Mantooth affiliated with any hospitals?
According to CMS data, Melinda Mantooth is affiliated with Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center and Providence Medford Medical Center.
When was this NPI record last updated?
The NPPES record for Melinda Mantooth was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Melinda Mae Mantooth, DO · NPI 1639708175
Internal Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since April 6, 2020.
## Identity
- **NPI:** 1639708175 (Entity type: Individual)
- **Enumerated:** April 6, 2020
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** DO217033 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 2801 N GANTENBEIN AVE, Portland, OR 97227-1623
- **Phone:** (503) 413-8407
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Legacy Clinics LLC (NPI 1902827272, Portland, OR); Legacy Salmon Creek Hospital (NPI 1356357784, Vancouver, WA); Sisters Of Providence In Oregon (NPI 1881770808, Shady Cove, OR); Providence Health & Services - Oregon (NPI 1093976243, Medford, OR); Asante Physician Partners (NPI 1922381326, Medford, OR); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Pacific Nw Un Of Hs, Col Of Osteopathic Medicine, class of 2020
## Record status
- **NPPES last updated:** September 1, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639708175) · Data from the CMS NPPES public registry.