Individual provider Active NPI

Michael L Melamed, M.D.

  • Specialist
  • Glen Cove, NY
National Provider Identifier
1194802546
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
148641 Issued in NY
Practice address
11 Jodi CT
Glen Cove, NY 11542-1470
Phone
(516) 759-0781
Fax
(516) 759-0750
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 148641 NY Primary

Addresses

Primary practice location

11 Jodi CT
Glen Cove, NY 11542-1470

Mailing address

11 Jodi CT
Glen Cove, NY 11542-1470
Phone (516) 759-0781

Other identifiers 1

IdentifierTypeStateIssuer
00739551MedicaidNY

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
I20040416000909 NY Practitioner - Psychiatry 0941295273 Practice locations: Glen Cove, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Jodi Court
Glen Cove, NY 11542-1470

11 Jodi CT
Glen Cove, NY 11542-1470
Phone (516) 759-0781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
148641NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194802546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JODI CT",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421470",
            "telephone_number": "516-759-0781",
            "fax_number": "516-759-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JODI CT",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421470",
            "telephone_number": "516-759-0781",
            "fax_number": "516-759-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAMED",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "148641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00739551",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.