Individual provider Active NPI

Melissa Lorae Tart

  • Behavior Analyst
  • Bay Shore, NY
National Provider Identifier
1265801831
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1217065 Issued in NY
Practice address
30 Oneill Ave
Bay Shore, NY 11706-6826
Phone
(347) 683-1789
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1217065 NY Primary

Addresses

Primary practice location

30 Oneill Ave
Bay Shore, NY 11706-6826

Mailing address

30 Oneill Ave
Bay Shore, NY 11706-6826
Phone (347) 683-1789

Other names 1

  • Melissa Lorae Rhodes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1217065NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1265801831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ONEILL AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066826",
            "telephone_number": "347-683-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ONEILL AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066826",
            "telephone_number": "347-683-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TART",
        "first_name": "MELISSA",
        "middle_name": "LORAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1217065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "RHODES",
            "middle_name": "LORAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.