Melissa Noel Polidori, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

662601 Issued in NY

Practice address

54 Fairfield St
Middleville, NY 13406-1820

Phone

(315) 982-0884

NPI assigned

Mar 20, 2023

Sex

Female

Sole proprietor

Yes

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.

• Remsen Central School

  • Local Education Agency (LEA)
  • Remsen, NY
  • NPI 1962530543
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

• Melissa Noel Moffatt Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 20, 2023.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1144922683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "REMSEN",
            "state": "NY",
            "postal_code": "134380406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 FAIRFIELD ST",
            "city": "MIDDLEVILLE",
            "state": "NY",
            "postal_code": "134061820",
            "telephone_number": "315-982-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIDORI",
        "first_name": "MELISSA",
        "middle_name": "NOEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "662601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MOFFATT",
            "middle_name": "NOEL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Peter Gilman, LCSW R
• Karin Harris

• All providers in Middleville, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.