Melissa Marie Bennett Provost, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

336151 Issued in NY

Practice address

30 W Main St
Mount Kisco, NY 10549-1910

Phone

(914) 666-3272

Fax

(914) 941-8626

NPI assigned

Jan 13, 2010

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Melissa Marie Bennett Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA

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.

• Boston Children's Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  Medicare reassignment NPD
• Open Door Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Port Chester, NY
  • NPI 1285893719
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  dba Boston Childrens Health Physicians Pediatric Endocrinology Division

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mamaroneck, NY
  • NPI 1487194155
  NPD
• Narco Freedom Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1174562003
  NPD (past)

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1245560242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-666-3272",
            "fax_number": "914-941-8626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Main St",
            "address_purpose": "LOCATION",
            "city": "Ossining",
            "state": "NY",
            "postal_code": "105624702",
            "country_code": "US",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-8626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "MELISSA",
        "middle_name": "MARIE BENNETT",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336151",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "605446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BENNETT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Premier Psychology Services, LLP
• Stephanie Marie Prevost, AUD
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy PC
• Dana Protomastro, NP
• Illyria Puharich, LCSW-R
• Manjju Agnes Pulickal, CRNA
• Susan Remmer Pulling, MS, RD
• Olga Pyrig, PHARM.D.
• Nicola Ann Quatrano, MD

• Family Nurse Practitioner in Mount Kisco, NY
• Providers in Mount Kisco, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.