Individual provider Active NPI

Melanie Adamo, MSPT

  • Physical Therapist
  • Medford, NY
National Provider Identifier
1063533461
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025142-1 Issued in NY
Practice address
8 Village Dr
Medford, NY 11763-4015
Phone
(631) 764-1990
NPI assigned
Apr 3, 2007
Last updated
Oct 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 025142-1 NY Primary

Addresses

Primary practice location

8 Village Dr
Medford, NY 11763-4015

Mailing address

8 Village Dr
Medford, NY 11763-4015
Phone (631) 764-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114002791 NY Practitioner - Physical Therapist in Private Practice 5597133090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025142-1NYMDPhysical Therapist
025142NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Physical Therapy PC Physical Therapist CurrentSince Oct 6, 2022 Accepting new patients
St Charles Hospital Corp Past Accepting new patients

Organizations & group practices 2

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1063533461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 VILLAGE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634015",
            "telephone_number": "631-764-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 VILLAGE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634015",
            "telephone_number": "631-764-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMO",
        "first_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025142-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.