NPIMap

Individual provider Active NPI

Brian James Melville, M.D.

  • Anesthesiology Physician
  • Bay Shore, NY
National Provider Identifier
1124280144
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
280025-1 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(800) 720-1664
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 237230 MA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 280025-1 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

301 E Main St
Bay Shore, NY 11706-8408

Other identifiers 1

IdentifierTypeStateIssuer
168922160OtherCTDRIVER LICENSE

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
I20151027001317 NY Practitioner - Anesthesiology 3375711633 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8480
Phone (631) 444-2975

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-0001
Phone (631) 638-0800

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
280025NYMDLicensed Practical Nurse
280025-1NYMDAnesthesiology Physician
237230MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Nov 15, 2016 Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Anesthesiology CurrentSince Jan 30, 2023 Accepting new patients
Long Island Anesthesia Physicians LLP Anesthesiology CurrentSince Aug 21, 2017 Accepting new patients
Endoscopy Center of Long Island LLC CurrentSince Mar 1, 2017 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1124280144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "800-720-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "237230",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "280025-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "168922160",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.