Individual provider Active NPI

Melanie Deckman

  • Clinical Social Worker
  • Boca Raton, FL
National Provider Identifier
1043849615
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17039 Issued in FL
Practice address
5500 N Military TRL Apt 403
Boca Raton, FL 33496-3565
Phone
(561) 789-6966
NPI assigned
Apr 6, 2020
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW17039 FL Primary

Addresses

Primary practice location

5500 N Military TRL Apt 403
Boca Raton, FL 33496-3565

Mailing address

5500 N Military TRL Apt 403
Boca Raton, FL 33496-3565
Phone (561) 789-6966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200528000758 FL Practitioner - Clinical Social Worker 5698196715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW17039FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 19, 2023 Accepting new patients
Direct Access Counseling & Supportive Services, LLC Clinical CurrentSince May 26, 2020 Accepting new patients
Ultima Rehab-FL LLC Single Specialty PastSince May 29, 2019 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1043849615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 N MILITARY TRL APT 403",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963565",
            "telephone_number": "561-789-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 N MILITARY TRL APT 403",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963565",
            "telephone_number": "561-789-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKMAN",
        "first_name": "MELANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.