Active NPI
Melkie Demissie
- Driver
- Rochester, NY
National Provider Identifier
1073054920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 773087314
- Practice address
- 1100 University Ave
Suite 208
Rochester, NY 14607-1653 - Phone
- (585) 506-2660
- NPI assigned
- Mar 12, 2017
- Last updated
- Mar 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 773087314 | NY | Primary |
Addresses
Primary practice location
1100 University Ave
Suite 208
Rochester, NY 14607-1653
Mailing address
1100 University Ave
Suite 208
Rochester, NY 14607-1653
Phone (585) 506-2660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 773087314 | NY | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489276800000",
"number": "1073054920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 UNIVERSITY AVE",
"address_2": "SUITE 208",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146071653",
"telephone_number": "585-506-2660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 UNIVERSITY AVE",
"address_2": "SUITE 208",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146071653",
"telephone_number": "585-506-2660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMISSIE",
"first_name": "MELKIE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-12",
"last_updated": "2017-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "NY",
"license": "773087314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.