Melissa Stark, RN, BSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

354372 Issued in NY

Practice address

500 5TH Ave
Owego, NY 13827-1620

Phone

(607) 687-1122

NPI assigned

Jan 10, 2012

Last updated

Jun 24, 2024By 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 3

Addresses

Other names 1

• Melissa Miner Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of Lourdes Memorial Hospital IncGroup PAC ID 1254237779, 249 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstark184056@direct-guthrie.org

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.

• Our Lady of Lourdes Memorial Hospital Inc.

  dba Lourdes

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment Care Compare group NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  dba Lourdes

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189
  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD
• Twin Tier Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Binghamton, NY
  • NPI 1770577470
  NPD
• Caregivers

  • Skilled Nursing Facility
  • Johnson City, NY
  • NPI 1366835209
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Our Lady of Lourdes Memorial Hospital Inc.

  dba Lourdes

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1417227299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 5TH AVE",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271620",
            "telephone_number": "607-687-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 5TH AVE",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271620",
            "telephone_number": "607-687-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "MELISSA",
        "credential": "RN, BSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "632392",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "588548",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MINER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Owego, NY
• Providers in Owego, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.