MELITZA MEJIA-CENTENO PA
NPI 1669097630
Physician Assistant in Salt Lake City, UT

Q: What is Melitza Mejia-centeno's NPI number?

The NPI number for Melitza Mejia-centeno is 1669097630. It was assigned to this individual provider in the NPPES registry on June 15, 2020.

Q: What is Melitza Mejia-centeno's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since June 15, 2020PECOS Enrolled

375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108(801) 585-0187 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2026, Jun 15, 2020 (2 updates tracked since 2020).

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About Melitza Mejia-centeno Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELITZA MEJIA-CENTENO PA (NPI 1669097630) is an individual physician assistant in Salt Lake City, Utah, licensed in California (PA68368) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Ukiah, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1669097630

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMELITZA MEJIA-CENTENOCredential: PA

Location Address375 S CHIPETA WAY STE ASalt Lake City, UT 84108-1261

Mailing Address1652 W 800 SSalt Lake City, UT 84104-3112 · (623) 205-5972

Phone(801) 585-0187

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 15, 2020

Last NPPES UpdateMay 28, 20262 updates tracked since enumeration

NPPES CertifiedMay 28, 2026

✔ NPI 1669097630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA68368

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

375 S CHIPETA WAY STE A, Salt Lake City, UT 84108

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Secondary Practice Location 1

Location 1333 Laws AveUkiah, CA 95482-6540 · Phone (707) 468-1010

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melitza Mejia-centeno Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335665009

PECOS Enrollment IDI20260610002984

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

JONATHAN ADAM CALVERT

Student in an Organized Health Care Education/Training Program