Melissa Jane Desouza, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

014927 Issued in NY

Practice address

3980 Sheridan Dr
Amherst, NY 14226-1727

Phone

(716) 929-2800

Fax

(716) 929-2819

NPI assigned

Jul 21, 2011

Last updated

Jan 23, 2017By the provider in NPPES

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

Other names 1

• Melissa Jane Puchalski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385
  NPD
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082
  NPD
• Digestive Health Physicians, P.C.

  • Gastroenterology Physician
  • Cheektowaga, NY
  • NPI 1255323762
  NPD (past)
• Wellnow Urgent Care Practice, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Rochester, NY
  • NPI 1013429752
  NPD (past)
• Wheatfield Family Medicine, LLC

  • Family Medicine Physician
  • North Tonawanda, NY
  • NPI 1770627622
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1376831594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 PARK CLUB LN",
            "address_2": "SUITE 300",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215269",
            "telephone_number": "716-836-4646",
            "fax_number": "716-836-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-929-2800",
            "fax_number": "716-929-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOUZA",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PUCHALSKI",
            "middle_name": "JANE",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marissa Desiderio, LCSW
• Ellen Denise Devere, M.D.
• Tania I. Didas, PA-C
• Kathryn Diekmann
• Jenna Elyse Diliberta, PA-C
• Ivy Jane Dimaculangan, AUD

• Medical Physician Assistant in Amherst, NY
• Providers in Amherst, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.