Active NPI
Melanie Ann Fernandez, PHD, ABPP
- Clinical Child & Adolescent Psychologist
- New York, NY
National Provider Identifier
1376779645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 017948
- Practice address
- 501 5TH Avenue
Suite 701
New York, NY 10017 - Phone
- (646) 397-9601
- NPI assigned
- Jun 1, 2009
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 017948 | NY | Primary |
Addresses
Primary practice location
501 5TH Avenue
Suite 701
New York, NY 10017
Mailing address
501 5TH Avenue
Suite 701
New York, NY 10017
Phone (646) 397-9601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 23, 2016 through Oct 23, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017948 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1376779645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 5TH AVENUE",
"address_2": "SUITE 701",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "646-397-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 5TH AVENUE",
"address_2": "SUITE 701",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "646-397-9601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MELANIE",
"middle_name": "ANN",
"credential": "PHD, ABPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-01",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "017948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.