Active NPI
Elisa Mary Mello, DDS
- Dentist
- New York, NY
National Provider Identifier
1124294475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0437291
- Practice address
- 8 East 84TH Street
New York, NY 10028 - Phone
- (212) 452-3344
- Fax
- (212) 412-9005
- NPI assigned
- May 7, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0437291 | NY | Primary |
Addresses
Primary practice location
8 East 84TH Street
New York, NY 10028
Mailing address
8 East 84TH Street
New York, NY 10028
Phone (212) 452-3344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 21, 2023 through Sep 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0437291 | NY | MD | Dentist |
| 043729 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1124294475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 EAST 84TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10028",
"telephone_number": "212-452-3344",
"fax_number": "212-412-9005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 EAST 84TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10028",
"telephone_number": "212-452-3344",
"fax_number": "212-412-9005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLO",
"first_name": "ELISA",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-07",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0437291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.