Individual provider Active NPI

Melanie Novick, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cortland, NY
National Provider Identifier
1154730232
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401711 Issued in NY
Practice address
10 N Main St
Cortland, NY 13045-2130
Phone
(607) 753-0234
Fax
(607) 753-0286
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401711 NY Primary

Addresses

Primary practice location

10 N Main St
Cortland, NY 13045-2130

Mailing address

10 N Main St
Cortland, NY 13045-2130
Phone (607) 753-0234

Other identifiers 1

IdentifierTypeStateIssuer
1336163963MedicaidNY

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
I20140908000056 NY Practitioner - Nurse Practitioner 4688892557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F401711NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Center at Ithaca CurrentSince Jul 6, 2017 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jul 6, 2017 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

Organizations & group practices 3

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": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1154730232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234",
            "fax_number": "607-753-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234",
            "fax_number": "607-753-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVICK",
        "first_name": "MELANIE",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336163963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.