Individual provider Active NPI

Melissa Pakusch, FNP

  • Family Nurse Practitioner
  • Penfield, NY
National Provider Identifier
1184460297
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354413 Issued in NY
Practice address
43 Willow Pond Way Ste 200
Penfield, NY 14526-2638
Phone
(585) 377-5420
NPI assigned
Jul 8, 2024
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 354413 NY Primary

Addresses

Primary practice location

43 Willow Pond Way Ste 200
Penfield, NY 14526-2638

Mailing address

43 Willow Pond Way Ste 200
Penfield, NY 14526-2638
Phone (585) 377-5420

Other practice location 1

229 Parrish St Ste 200
Canandaigua, NY 14424-1791
Phone (585) 377-5420

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
I20241202001967 NY Practitioner - Nurse Practitioner 5698200566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penfield Obstetrics and Gynecology LLPGroup PAC ID 0547233900, 7 clinicians

Practice addresses (Care Compare)

43 Willow Pond Way
Suite 200
Penfield, NY 14526-2638
Phone (585) 377-5420

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penfield Obstetrics and Gynecology LLP CurrentSince Sep 5, 2024 Accepting new patients

Locations

229 Parrish St
Ste 200
Canandaigua, NY 14424
Phone (585) 377-5420

43 Willow Pond Way
Ste 200
Penfield, NY 14526
Phone (585) 377-5420

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1184460297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WILLOW POND WAY STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262638",
            "telephone_number": "585-377-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WILLOW POND WAY STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262638",
            "telephone_number": "585-377-5420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 Parrish St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Canandaigua",
            "state": "NY",
            "postal_code": "144241791",
            "country_code": "US",
            "telephone_number": "585-377-5420",
            "fax_number": "585-377-3690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAKUSCH",
        "first_name": "MELISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.