Melissa Antonow

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F382794 Issued in NY

Practice address

154 Commack Rd Ste 100
Commack, NY 11725-3457

Phone

(631) 499-8282

NPI assigned

Apr 4, 2018

Last updated

Jul 14, 2022By 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 3

Addresses

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

Networks

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

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.

• Allied Physicians Group, PLLC

  • Pediatrics Physician
  • Melville, NY
  • NPI 1396944799
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1255837407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 69TH PL",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791126",
            "telephone_number": "917-922-7005",
            "fax_number": "917-922-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 COMMACK RD STE 100",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253457",
            "telephone_number": "631-499-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 Fresh Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113853261",
            "country_code": "US",
            "telephone_number": "718-497-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONOW",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F3822794-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382794",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "631114",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Anber, PA-C
• Andersenacu Inc
• Andrew Joseph Leo, MD P.C.
• Andrew L Berger, PH.D., PC
• Anna Lerner Angeles MD PC
• Nicholas Frederick Aquino, AU.D
• Jamie Elissa Aranoff, CCC-SLP
• Jenna Aranoff, M.A.
• Elizabeth Archey, LCSW
• Peter John Arebalo IV, LMT

• Pediatric Nurse Practitioner in Commack, NY
• Providers in Commack, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.