Individual provider Active NPI

Melvi Villanueva Tay, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1336581255
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R195043 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 328-5720
Fax
(410) 328-5685
NPI assigned
Jul 19, 2013
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R195043 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 328-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20151006000278 MD Practitioner - Nurse Practitioner 0547403917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 448-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R195043MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians PA CurrentSince Mar 25, 2019 Accepting new patients
Synergy Medical Group CurrentSince Aug 12, 2025 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Mar 25, 2019 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
Synergy Medical Group LLC CurrentSince Aug 12, 2025 Accepting new patients
Synergy Medical Group LLC Current Accepting new patients
Synergy Medical Group LLC Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

14014 Marsh Pike
Hagerstown, MD 21742
Phone (301) 733-8700

4922 Lasalle Rd
Hyattsville, MD 20782
Phone (301) 445-3501

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

4011 Randolph Rd
Wheaton, MD 20902
Phone (301) 933-2500

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

Interoperability endpoints

  • Direct secure messaging: mtay565502@direct.umm.edu

Organizations & group practices 7

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1336581255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-8040",
            "fax_number": "443-462-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-328-5720",
            "fax_number": "410-328-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAY",
        "first_name": "MELVI",
        "middle_name": "VILLANUEVA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R195043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.