Individual provider Active NPI

Noel Melon Nuevas

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1598253759
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
63 08 39TH Ave
Woodside, NY 11377
Phone
(754) 252-4892
NPI assigned
Apr 24, 2018
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Physical Therapy Assistant 225200000X NU

Addresses

Primary practice location

63 08 39TH Ave
Woodside, NY 11377

Mailing address

4022 201St St # 2F
Bayside, NY 11361-1837
Phone (929) 507-2685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126001216 NY Practitioner - Physical Therapist in Private Practice 3476967845 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. Single Specialty CurrentSince Apr 1, 2022 Accepting new patients
Premier Healthcare, Inc. Single Specialty Current Accepting new patients
Premier Healthcare, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC Single Specialty CurrentSince Jan 1, 2021 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

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, 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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1598253759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 201ST ST # 2F",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611837",
            "telephone_number": "929-507-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 08 39TH AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "11377",
            "telephone_number": "754-252-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUEVAS",
        "first_name": "NOEL MELON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.