NPIMap

Individual provider Active NPI

Melissa Ann Breault, FNP

  • Family Nurse Practitioner
  • Troy, NY
National Provider Identifier
1083971493
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336764-1 Issued in NY
Practice address
258 Hoosick St
Suite 101
Troy, NY 12180-2427
Phone
(518) 274-5660
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336764-1 NY Primary

Addresses

Primary practice location

258 Hoosick St
Suite 101
Troy, NY 12180-2427

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000066 NY Practitioner - Nurse Practitioner 1052562311 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153
  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336764-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Sep 8, 2019 Accepting new patients
St. Peter'S Hospital of the City of Albany Family CurrentSince Sep 8, 2019 Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Mar 15, 2017 Accepting new patients
St. Peter'S Hospitalof the City of Albany Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

315 S Manning Blvd
Unit 3563C
Albany, NY 12208
Phone (518) 525-6560

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

258 Hoosick St
Ste 101
Troy, NY 12180
Phone (518) 274-5660

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Interoperability endpoints

  • Direct secure messaging: mbreault150217@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1083971493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 HOOSICK ST",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802427",
            "telephone_number": "518-274-5660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "12180",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREAULT",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336764-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.