Individual provider Active NPI

Melanie Ann Dunham, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1548303571
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
334442 Issued in NY
Practice address
819 S Salina St
Syracuse, NY 13202-3527
Phone
(315) 476-7921
NPI assigned
Feb 15, 2007
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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 334442 NY Primary

Addresses

Primary practice location

819 S Salina St
Syracuse, NY 13202-3527

Mailing address

819 S Salina St
Syracuse, NY 13202-3527
Phone (315) 476-7921

Other identifiers 1

IdentifierTypeStateIssuer
02864464MedicaidNY

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
I20160222000295 NY Practitioner - Nurse Practitioner 7012958770 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse Family CurrentSince Dec 1, 2015 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Dec 1, 2015 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jun 1, 2017 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients
Winslow Indian Health Care Center, Inc Past Accepting new patients

Locations

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

Interoperability endpoints

  • Direct secure messaging: mdunham50017@direct.upstate.edu

Organizations & group practices 5

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1548303571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023527",
            "telephone_number": "315-476-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023527",
            "telephone_number": "315-476-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02864464",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.