Active NPI
Melanie M Tidman, M.A., OTR/L
- Pediatric Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1366487027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- NM 106
- Practice address
- 521 Vineyard Rd NE
Albuquerque, NM 87113-1055 - Phone
- (505) 344-5756
- Fax
- (505) 341-4810
- NPI assigned
- Jun 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | NM 106 | NM | Primary |
Addresses
Primary practice location
521 Vineyard Rd NE
Albuquerque, NM 87113-1055
Mailing address
521 Vineyard Rd NE
Albuquerque, NM 87113-1055
Phone (505) 344-5756
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26814 | Other | NM | PRESBYTERIAN HEALTH PLAN |
| 000D1112 | Medicaid | NM | |
| NM00E372 | Other | NM | BLUE CROSS PROVIDER ID# |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM 106 | NM | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366487027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 VINEYARD RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871131055",
"telephone_number": "505-344-5756",
"fax_number": "505-341-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 VINEYARD RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871131055",
"telephone_number": "505-344-5756",
"fax_number": "505-341-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDMAN",
"first_name": "MELANIE",
"middle_name": "M",
"credential": "M.A., OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NM",
"license": "NM 106",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLAN",
"identifier": "26814",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000D1112",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID#",
"identifier": "NM00E372",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.