Individual provider Active NPI

Melissa Gelsomino, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mineral Ridge, OH
National Provider Identifier
1487264313
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0027312 Issued in OH
Practice address
3695 Saint Marys Dr
Mineral Ridge, OH 44440-9003
Phone
(330) 883-5894
NPI assigned
Aug 5, 2020
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0027312 OH Primary
Registered Nurse 163W00000X RN-408375 OH

Addresses

Primary practice location

3695 Saint Marys Dr
Mineral Ridge, OH 44440-9003

Mailing address

3695 Saint Marys Dr
Mineral Ridge, OH 44440-9003
Phone (330) 883-5894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210518002638 OH Practitioner - Nurse Practitioner 6406255710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Foundations, LLCGroup PAC ID 5597161026, 5 clinicians

Practice addresses (Care Compare)

1392 High St
Suite 205
Wadsworth, OH 44281-8257
Phone (330) 227-4518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN-408375OHMDRegistered Nurse
APRN.CNP.0027312OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avo Behavioral Health LLC CurrentSince Jan 9, 2021 Accepting new patients
Avo Behavioral Health LLC CurrentSince Jan 9, 2021 Accepting new patients
Psych Foundations, LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

3745 Whipple Ave NW
Canton, OH 44718
Phone (330) 331-7506

3745 Whipple Ave NW
Ste A
Canton, OH 44718
Phone (330) 331-7506

1392 High St
Ste 205
Wadsworth, OH 44281
Phone (330) 227-4518

273 Main St
Ste 300
Wadsworth, OH 44281
Phone (330) 227-4518

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1487264313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 SAINT MARYS DR",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409003",
            "telephone_number": "330-883-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 SAINT MARYS DR",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409003",
            "telephone_number": "330-883-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELSOMINO",
        "first_name": "MELISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0027312",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN-408375",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Ridge, OH

Sources for this page

Verify at the official NPI Registry.