Melanie Douglas, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

015826-1 Issued in NY

Practice address

355 Bard Ave
Staten Island, NY 10310-1664

Phone

(718) 818-1234

Fax

(718) 818-1252

NPI assigned

Oct 18, 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

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

79.57 of 100Reported as group

Quality

70.48

Improvement activities

40

Cost

69.36

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: mdouglas24644@mskcc.direct-ci.com

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.

• The Mount Sinai Hospital

  • General Acute Care Hospital
  • Long Island City, NY
  • NPI 1013948595
  Medicare reassignment NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• Memorial Hematology Lymphoma Group

  • Hematology & Oncology Physician
  • New York, NY
  • NPI 1891766366
  Medicare reassignment
• Memorial Infectious Disease Group

  • Infectious Disease Physician
  • New York, NY
  • NPI 1619948189
  Medicare reassignment
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD
• Mount Sinai Hospital

  • Community/Retail Pharmacy
  • Astoria, NY
  • NPI 1588408421
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1376896142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-1234",
            "fax_number": "718-818-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-1234",
            "fax_number": "718-818-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MELANIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "015826-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Double R Consulting
• Dianne Barbara Dougherty, FNP
• Meghan Dougherty, RN
• Douglas E Menikheim MD Jeffrey S Kalman MD & C Yiachos MD PC
• Jade Douglas
• Patricia Douglas, MS
• Andrea Kathryn Doumar, OTR/L
• Jennifer Dove, RN
• Matthew Lawrence Dove, LMSW
• Annemarie Dowling-Castronovo, PHD, RN, GNP-BC

• Surgical Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.