Melissa D'Amato, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4904 Issued in CT

Practice address

140 Hazard Ave Ste 105
Enfield, CT 06082-5424

Phone

(860) 714-9733

Fax

(860) 714-8136

NPI assigned

Feb 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• Mrs. Melissa Cornes Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissaacquaviva@nslijmedgr.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nes Medical Services of Northern Connecticut, P.C.

  • Emergency Medicine Physician
  • Putnam, CT
  • NPI 1447231865
  Medicare reassignment NPD
• University of Connecticut Health Center

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769
  Medicare reassignment NPD
• Connecticut Imaging Partners, LLC

  • Diagnostic Radiology Physician
  • Wethersfield, CT
  • NPI 1740315761
  Medicare reassignment
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment
• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1851571608

  CT

  Medicare reassignment
• University of Connecticut Health Center

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1104809375
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1023083292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HAZARD AVE STE 105",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825424",
            "telephone_number": "860-714-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HAZARD AVE STE 105",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825424",
            "telephone_number": "860-714-9733",
            "fax_number": "860-714-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMATO",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010711-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "004904",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104557",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4904",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000728800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685778036A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P00727972",
            "identifier": "RAILROAD MEDICARE",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdamato42756@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CORNES",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Laquerre Cunningham, MSPT
• Andrea Rebecca Curry, LCSW
• George Brant Curry Jr., D.C.
• Jessica Cushing
• CVGV Surgical Associates, PC.
• Eileen Daigle
• Lisa Daigneau
• Miri Daly, DNP
• Edwin Steven Damon, D.P.M.
• George H Daniels

• Medical Physician Assistant in Enfield, CT
• Providers in Enfield, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.