Individual provider Active NPI

Melissa Anne Pawelczak, MD

  • Pediatric Endocrinology Physician
  • New York, NY
National Provider Identifier
1356584502
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
244260 Issued in NY
Practice address
550 1St Ave
3A
New York, NY 10016-6402
Phone
(212) 263-6462
Fax
(212) 562-3273
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 244260 NY Primary

Addresses

Primary practice location

550 1St Ave
3A
New York, NY 10016-6402

Mailing address

121 Madison Ave
Apartment 12a
New York, NY 10016-7033
Phone (212) 263-6462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120207000309 NY Practitioner - Pediatric MedicinePractitioner - Endocrinology 7911164728 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 17, 2018 Accepting new patients

Locations

376 E Main St
Bay Shore, NY 11706
Phone (631) 396-7000

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

550 1st Ave
#3A
New York, NY 10016
Phone (212) 263-6462

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: melissapawelczak@nslijmedgr.allscriptsdirect.net

Organizations & group practices 1

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1356584502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MADISON AVE",
            "address_2": "APARTMENT 12A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167033",
            "telephone_number": "212-263-6462",
            "fax_number": "212-562-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "address_2": "3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-6462",
            "fax_number": "212-562-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWELCZAK",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "244260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.