Active NPI
Melissa Edwards
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1295398089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024472
- Practice address
- 279 E 196TH St
Bronx, NY 10458-3507 - Phone
- (718) 584-4450
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024472 | NY | Primary |
Addresses
Primary practice location
279 E 196TH St
Bronx, NY 10458-3507
Mailing address
2694 Briggs Ave Apt 4S
Bronx, NY 10458-4086
Other practice location 1
500 Bi County Blvd Ste 450
Farmingdale, NY 11735-3995
Phone (718) 264-1640
Other practice location 2
3391 Richmond Ave
Staten Island, NY 10312-2025
Phone (718) 608-9170
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
| License | State | Type | Specialty |
|---|---|---|---|
| 024472 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Therapy Placement Services Inc | Past | Accepting new patients | |
| New York Therapy Placement Services Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Farmingdale, NY
- NPI 1548708118
-
- Early Intervention Provider Agency
- Port Jefferson Station, NY
- NPI 1558507210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1295398089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2694 BRIGGS AVE APT 4S",
"city": "BRONX",
"state": "NY",
"postal_code": "104584086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 E 196TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104583507",
"telephone_number": "718-584-4450"
}
],
"practiceLocations": [
{
"address_1": "500 Bi County Blvd Ste 450",
"address_purpose": "LOCATION",
"city": "Farmingdale",
"state": "NY",
"postal_code": "117353995",
"country_code": "US",
"telephone_number": "718-264-1640",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3391 Richmond Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103122025",
"country_code": "US",
"telephone_number": "718-608-9170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-17",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.