Melissa Ellen Dere, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

274910 Issued in NY

Practice address

732 5TH Ave
Brooklyn, NY 11232

Phone

(212) 226-7666

Fax

(212) 202-7988

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: melissadere@mai.allscriptsdirect.net

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.

• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Tribeca Pediatrics, PLLC

  • Pediatric Adolescent Medicine Physician
  • New York, NY
  • NPI 1588635171
  NPD (past)
• Tribeca Pediatrics

  • Pediatrics Physician
  • Jersey City, NJ
  • NPI 1356000160
  NPD (past)

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1376804096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112321306",
            "telephone_number": "212-226-7666",
            "fax_number": "212-202-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11232",
            "telephone_number": "212-226-7666",
            "fax_number": "212-202-7988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11232",
            "country_code": "US",
            "telephone_number": "212-226-7666",
            "fax_number": "212-202-7988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERE",
        "first_name": "MELISSA",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "274910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dept of Education
• Kelsey Morgan Depue, LMHC
• Joseph Der
• Rickie E Derdik
• David A. Derdzinski, M.D.
• Erimas Nimane Dereje
• Gabriella Jennifer Deren
• Rachel Michelle Deren
• Giorgi Derevenskikh, MD
• Deborah Deriso, COTA

• Pediatric Adolescent Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Adolescent Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.