Melissa E Mitkoff, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F430108-1 Issued in NY

Practice address

5 Palisades Dr
Ste100
Albany, NY 12205-6433

Phone

(518) 438-4493

Fax

(518) 438-5803

NPI assigned

Sep 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter'S Hospital Hospital, Albany, NY, CCN 330057

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmitkoff789357@direct.trinity-health.org

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.

• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834
  Medicare reassignment Care Compare group
• St. Peter'S Health Partners Medical Associates, P.C.

  • Pediatrics Physician
  • Slingerlands, NY
  • NPI 1669717260

  Nurse Practitioner

  NPD (past)

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

• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1164417457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PALISADES DR",
            "address_2": "STE100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122056433",
            "telephone_number": "518-438-4493",
            "fax_number": "518-438-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITKOFF",
        "first_name": "MELISSA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F430108-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02049558",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5 Palisades Dr",
            "address_2": "STE100",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122056433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Anne Mitchell, PA
• Robin Mitchell, RN
• Rose Mitchell, CM
• Victoria Marie Mitchell, CNM
• Alphonso Mitchum, LCSW
• Nathan Bernard Mitkoff, M.D.
• Neil Mitnick
• Nicole Mitstifer, LPN
• Srinivas R Mitta
• Rosemary L Mix, CCC-SLP

• Nurse Practitioner in Albany, NY
• Providers in Albany, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.