Individual provider Active NPI

Melanie Paul-Hackett, APRN

  • Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1225799034
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11016765 Issued in FL
Practice address
22641 Caravelle Cir
Boca Raton, FL 33433-5914
Phone
(561) 866-3562
NPI assigned
Jan 4, 2022
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11016765 FL Primary

Addresses

Primary practice location

22641 Caravelle Cir
Boca Raton, FL 33433-5914

Mailing address

22641 Caravelle Cir
Boca Raton, FL 33433-5914
Phone (561) 866-3562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240626000569 NJ Practitioner - Nurse Practitioner 7517353998 Reassigns benefits to 1 organization
I20251210001492 WV Practitioner - Nurse Practitioner 7517353998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Dallas, TX 75244-5074

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016765FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC Nurse Practitioner CurrentSince Jun 1, 2024 Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 650-7800

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1225799034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22641 CARAVELLE CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335914",
            "telephone_number": "561-866-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22641 CARAVELLE CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335914",
            "telephone_number": "561-866-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL-HACKETT",
        "first_name": "MELANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11016765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.