NPIMap

Individual provider Active NPI

Melanie S Ice, DO

  • Family Medicine Physician
  • West Chester, PA
National Provider Identifier
1417987579
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS008097L Issued in PA
Practice address
1055 Andrew Dr
Suite B
West Chester, PA 19380-3446
Phone
(610) 436-4448
NPI assigned
Jul 4, 2006
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05008097L PA
Family Medicine Physician 207Q00000X OS008097L PA Primary

Addresses

Primary practice location

1055 Andrew Dr
Suite B
West Chester, PA 19380-3446

Mailing address

1055 Andrew Dr
Suite B
West Chester, PA 19380-3446
Phone (610) 436-4448

Other identifiers 1

IdentifierTypeStateIssuer
0014516050002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231006002109 FL Practitioner - Family Practice 3678618931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2155 SE Federal Hwy
Wellmed at South Stuart
Stuart, FL 34994-4514
Phone (772) 223-9630

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05008097LPAMDFamily Medicine Physician
OS008097LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc Family Medicine CurrentSince Oct 30, 2023 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Urologic Associates of Chester County, Inc.. Past Accepting new patients

Locations

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

1055 Andrew Dr
Ste B
West Chester, PA 19380
Phone (610) 436-4448

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: melanie.ice@wellmed.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1417987579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 ANDREW DR",
            "address_2": "SUITE B",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193803446",
            "telephone_number": "610-436-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 ANDREW DR",
            "address_2": "SUITE B",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193803446",
            "telephone_number": "610-436-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "MELANIE",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "05008097L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008097L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014516050002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.