Individual provider Active NPI

Melisande Joy Ploutz, PNP

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1487091617
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382382 Issued in NY
Practice address
601 Elmwood Ave
Box 661
Rochester, NY 14642-8410
Phone
(585) 275-1000
Fax
(585) 276-1985
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F382382 NY Primary
Medical Physician Assistant 363AM0700X 382382 NY

Addresses

Primary practice location

601 Elmwood Ave
Box 661
Rochester, NY 14642-8410

Mailing address

601 Elmwood Ave
Box 661
Rochester, NY 14642-8410
Phone (585) 275-1000

Other identifiers 1

IdentifierTypeStateIssuer
03596870MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmccheyne24679@direct.urmc.rochester.edu Direct
Direct Messaging Address mmccheyne24679@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130906000005 NY Practitioner - Nurse Practitioner 5395988687 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
382382NYMDMedical Physician Assistant
F382382NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Hematology Clinical Group Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Nov 1, 2019 Accepting new patients
University of Rochester CurrentSince Nov 1, 2019 Accepting new patients
Pediatric Plastic Surgery of the University of Rochester CurrentSince Aug 22, 2018 Accepting new patients
University of Rochester Current Accepting new patients
U of R Plastic Surgeons CurrentSince Aug 22, 2018 Accepting new patients

Locations

601 Elmwood Ave
#661
Rochester, NY 14642
Phone (585) 275-3376

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: mmccheyne24679@direct.urmc.rochester.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1487091617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 661",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428410",
            "telephone_number": "585-275-1000",
            "fax_number": "585-276-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 661",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428410",
            "telephone_number": "585-275-1000",
            "fax_number": "585-276-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOUTZ",
        "first_name": "MELISANDE",
        "middle_name": "JOY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382382",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "382382",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03596870",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmccheyne24679@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmccheyne24679@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.