Individual provider Active NPI

Melissa Rodzen, PA-C

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1578043881
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022482 Issued in NY
Practice address
285 Middle Country Rd
Smithtown, NY 11787-2978
Phone
(631) 509-0390
Fax
(631) 656-0875
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022482 NY Primary

Addresses

Primary practice location

285 Middle Country Rd
Smithtown, NY 11787-2978

Mailing address

285 Middle Country Rd
Smithtown, NY 11787-2978
Phone (631) 509-0390

Other identifiers 1

IdentifierTypeStateIssuer
022482OtherNYLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrodzen360335@nyumc.direct-ci.com

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
I20181010001182 NY Practitioner - Physician Assistant 9739431362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022482NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Community Hospital at NYU Langone Health CurrentSince Feb 24, 2019 Accepting new patients
New York University CurrentSince Aug 20, 2020 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. Physician Assistant CurrentSince Feb 24, 2019 Accepting new patients
New York University CurrentSince Aug 20, 2020 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1578043881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872978",
            "telephone_number": "631-509-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872978",
            "telephone_number": "631-509-0390",
            "fax_number": "631-656-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODZEN",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "022482",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrodzen360335@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.