Individual provider Active NPI

Melissa Anne Belluomini, PNP

  • Pediatric Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1285148775
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP-03419 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1819
NPI assigned
Nov 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP-03419 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930

Mailing address

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20180328000925 NM Practitioner - Nurse Practitioner 4284996455 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-03419NMMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2018 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2018 Accepting new patients
After Hours Pediatrics PC Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1285148775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLUOMINI",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "CNP-03419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.