Individual provider Active NPI

Melissa Taylor-Bobb, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1528084688
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334581-1 Issued in NY
Practice address
441 E Fordham Rd
Student Health Center -Ohare Hall
Bronx, NY 10458-5149
Phone
(718) 817-4160
Fax
(718) 817-3218
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F334581-1 NY Primary

Addresses

Primary practice location

441 E Fordham Rd
Student Health Center -Ohare Hall
Bronx, NY 10458-5149

Mailing address

441 E. Fordham Rd.
Student Health Center -Ohare Hall
Bronx, NY 10458
Phone (718) 817-4160

Other identifiers 1

IdentifierTypeStateIssuer
02759066MedicaidNY

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
I20060804000313 NY Practitioner - Nurse Practitioner 0446253751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F334581-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Professional Physician Services, P.C. CurrentSince Apr 1, 2024 Accepting new patients
Brookdale Hospital Medical Center CurrentSince May 20, 2020 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince May 20, 2020 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1528084688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 E. FORDHAM RD.",
            "address_2": "STUDENT HEALTH CENTER -OHARE HALL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-817-4160",
            "fax_number": "718-817-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 E FORDHAM RD",
            "address_2": "STUDENT HEALTH CENTER -OHARE HALL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585149",
            "telephone_number": "718-817-4160",
            "fax_number": "718-817-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-BOBB",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334581-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02759066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.