Melissa Clarice Komrosky, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN 611446 Issued in CA

Practice address

2400 Moorpark Ave
Suite 100
San Jose, CA 95128-2631

Phone

(408) 885-5167

Fax

(408) 885-5169

NPI assigned

Aug 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Interoperability endpoints

• Direct secure messaging: mkomrosky6375@santaclaravalley.direct-ci.net

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.

• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • Gilroy, CA
  • NPI 1922093533
  NPD

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1326030867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16770 CABERNET CIR",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950377081",
            "telephone_number": "650-224-4854",
            "fax_number": "408-782-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "address_2": "SUITE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "408-885-5167",
            "fax_number": "408-885-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMROSKY",
        "first_name": "MELISSA",
        "middle_name": "CLARICE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN 611446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neelima Komatineni, M.D.
• Sia Mariama Komba, R.N.
• Tomoko Komishi
• Suree Komonrujinunt, RPH
• Gerard James Komp, PHARMD
• Shahe Komshian, M.D.
• Stephanie Komura, MD
• Taiki Kondo
• Alexander Kondrakhin
• Brian Robert Kong, D.D.S.

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.