Individual provider Active NPI

Melanie Samantha Ulysse, LPN

  • Licensed Practical Nurse
  • South Ozone Park, NY
National Provider Identifier
1386937522
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
300370-1 Issued in NY
Practice address
11544 Van Wyck Expy
South Ozone Park, NY 11420-2230
Phone
(516) 451-1717
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 300370-1 NY Primary

Addresses

Primary practice location

11544 Van Wyck Expy
South Ozone Park, NY 11420-2230

Mailing address

11544 Van Wyck Expy
South Ozone Park, NY 11420-2230
Phone (516) 451-1717

Other identifiers 1

IdentifierTypeStateIssuer
300370MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
300370-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1386937522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11544 VAN WYCK EXPY",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202230",
            "telephone_number": "516-451-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11544 VAN WYCK EXPY",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202230",
            "telephone_number": "516-451-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULYSSE",
        "first_name": "MELANIE",
        "middle_name": "SAMANTHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "300370-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300370",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.