Individual provider Active NPI

Igor Melyokhin, MD

  • Anesthesiology Physician
  • Ramsey, NJ
National Provider Identifier
1336155019
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07642300 Issued in NJ
Practice address
500 N Franklin Tpke
Suite 206
Ramsey, NJ 07446-1177
Phone
(201) 962-7282
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07642300 NJ Primary

Addresses

Primary practice location

500 N Franklin Tpke
Suite 206
Ramsey, NJ 07446-1177

Mailing address

255 W Michigan Ave
P. O. Box 1123
Jackson, MI 49201-2218
Phone (517) 787-6440

Other identifiers 1

IdentifierTypeStateIssuer
0098272MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060201000832 NJ Practitioner - Anesthesiology 9335153006 Reassigns benefits to 1 organization
I20070223000033 NY Practitioner - Anesthesiology 9335153006 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince May 10, 2017 Accepting new patients
State of New York CurrentSince May 10, 2017 Accepting new patients
State of New York Comptrollers Office Current Accepting new patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince May 23, 2016 Accepting new patients
Ramapo Anesthesiologists, PC Anesthesiology PastSince Mar 5, 2007 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

500 N Franklin Tpke
Ramsey, NJ 07446
Phone (201) 995-9975

500 N Franklin Tpke
Ste 206
Ramsey, NJ 07446
Phone (201) 962-7282

500 N Franklin Tpke
#C
Ramsey, NJ 07446
Phone (201) 962-7282

Organizations & group practices 5

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1336155019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "P. O. BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N FRANKLIN TPKE",
            "address_2": "SUITE 206",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461177",
            "telephone_number": "201-962-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELYOKHIN",
        "first_name": "IGOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07642300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098272",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramsey, NJ

Sources for this page

Verify at the official NPI Registry.