Individual provider Active NPI

Melody Martin

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1164870085
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301854 Issued in NY
Practice address
114 W 17TH St
New York, NY 10011-5433
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jun 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 301854 NY Primary

Addresses

Primary practice location

114 W 17TH St
New York, NY 10011-5433

Mailing address

129 W 29TH St FL 10
New York, NY 10001-5105
Phone (415) 658-6791

Other practice location 1

555 N Duke St
Lancaster, PA 17602-2250
Phone (717) 544-4950

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200220001435 NY Practitioner - Family Practice 4789976226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
One Medical of Ny PCGroup PAC ID 3274713110, 72 clinicians
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

114 W 17TH St
New York, NY 10011-0022
Phone (888) 663-6331

114 W 17TH St
New York, NY 10011-5433
Phone (888) 663-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Family Medicine CurrentSince Jan 12, 2026 Accepting new patients
Montefiore Medical Center CurrentSince Jan 12, 2026 Accepting new patients
One Medical of Ny, P.C. Family Medicine CurrentSince Jan 12, 2026 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

408 W 14th St
Ste 201
New York, NY 10014
Phone (212) 530-0639

919 3rd Ave
Ste 105
New York, NY 10022
Phone (212) 530-0650

Organizations & group practices 5

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1164870085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W 29TH ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015105",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115433",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 N Duke St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176022250",
            "country_code": "US",
            "telephone_number": "717-544-4950",
            "fax_number": "717-544-4149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.