Active NPI
Robert J. Melanson, PA-C
- Physician Assistant
- Kingston, NY
National Provider Identifier
1386674653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0066681
- Practice address
- 396 Broadway
Kingston, NY 12401-4626 - Phone
- (845) 334-2890
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0066681 | NY | Primary |
Addresses
Primary practice location
396 Broadway
Kingston, NY 12401-4626
Mailing address
PO Box 10730
Westminster, CA 92685-0730
Phone (562) 809-3548
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02004451 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 48.64 of 100
- Quality
- 9.4
- Improvement activities
- 40
- Cost
- 82.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006668 | NY | MD | Acupuncturist |
| 0066681 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Arizona Inc | Current | Accepting new patients | |
| Eos Medical Group PC | Past | Accepting new patients | |
| Atlantic Physician Services of Maryland, PC | Physician Assistant | Past | Accepting new patients |
| Island Medical Empire State, PLLC | Physician Assistant | Past | Accepting new patients |
Locations
2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100
4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800
405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170
Organizations & group practices 9
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.
-
- Emergency Medicine Physician
- Poughkeepsie, NY
- NPI 1093759847
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
-
- Emergency Medicine Physician
- Hobbs, NM
- NPI 1457636706
-
- Emergency Medicine Physician
- Hobbs, NM
- NPI 1477031094
-
- Emergency Medicine Physician
- Las Cruces, NM
- NPI 1598446171
-
- Emergency Medicine Physician
- Carmel, NY
- NPI 1730119926
-
- Emergency Medicine Physician
- Oneonta, NY
- NPI 1053623041
Physician Assistant
-
- Physician Assistant
- Baltimore, MD
- NPI 1174632376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1386674653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10730",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926850730",
"telephone_number": "562-809-3548",
"fax_number": "562-468-0726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "396 BROADWAY",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124014626",
"telephone_number": "845-334-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELANSON",
"first_name": "ROBERT",
"middle_name": "J.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "0066681",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02004451",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.