Individual provider Active NPI

Melida Delcina Knibbs, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1154518280
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
380894-1 Issued in NY
Practice address
521 W 181St St
New York, NY 10033-5102
Phone
(347) 756-6000
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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 380894-1 NY Primary

Addresses

Primary practice location

521 W 181St St
New York, NY 10033-5102

Mailing address

521 West 181 Street
New York, NY 10033-8779
Phone (347) 756-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130315000068 NY Practitioner - Nurse Practitioner 9335384692 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audubon Primary Care Medicine PLLCGroup PAC ID 5890920656, 6 clinicians

Practice addresses (Care Compare)

325 Audubon Ave
New York, NY 10033-4204

521 W 181St St
New York, NY 10033-5102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
380894-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon Primary Care Medicine PLLC CurrentSince Jun 3, 2013 Accepting new patients
181St Street Medical P.C. CurrentSince Mar 1, 2014 Accepting new patients
Heritage Health and Housing, Inc PastSince Feb 28, 2014 Accepting new patients

Locations

521 W 181st St
New York, NY 10033
Phone (347) 756-6000

325 Audubon Ave
New York, NY 10033
Phone (718) 664-7679

Networks

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

Interoperability endpoints

  • Direct secure messaging: melida.knibbs@cgm.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1154518280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 WEST 181 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100338779",
            "telephone_number": "347-756-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W 181ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100335102",
            "telephone_number": "347-756-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIBBS",
        "first_name": "MELIDA",
        "middle_name": "DELCINA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "380894-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.