Michael Anthony Mennella, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

191160 Issued in NY

Practice address

496 Smithtown Byp
Suite LL1
Smithtown, NY 11787-5005

Phone

(631) 724-6333

NPI assigned

Mar 10, 2007

Last updated

Sep 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Family Residences and Essential Enterprises, Inc.

  dba Terry's Place

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Old Bethpage, NY
  • NPI 1497943757
  NPD (past)

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1366574873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE LL1",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-793-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE LL1",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-724-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNELLA",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-10",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "191160",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "191160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Murphy Acupuncture P.C.
• Melanie Perlson
• Scarlet Yvonne Melendez, R.N.
• Dara Melnick
• Mary L Mendes, LCSW, CEAP
• Mens Health of Smithtown
• Mental Health Nurse Practitioner Consultation Services PC
• Stephanie Jeanne Menzer, MA CCC-SLP
• Alicia Mercado
• Heidy Nicole Merius, N.P.

• Psychiatry Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.