Individual provider Active NPI

Michelle Melo, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1598385809
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
325566-01 Issued in NY
Practice address
1262 Boston Rd
Bronx, NY 10456-3541
Phone
(718) 569-7929
NPI assigned
Apr 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 325566-01 NY Primary

Addresses

Primary practice location

1262 Boston Rd
Bronx, NY 10456-3541

Mailing address

1262 Boston Rd
Bronx, NY 10456-3541
Phone (718) 569-7929

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507000476 NY Practitioner - Internal Medicine 9638589617 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
325566-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
181St Street Medical P.C. Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
CCN General Medicine PLLC Internal Medicine CurrentSince Mar 27, 2024 Accepting new patients

Locations

1262 Boston Rd
#2
Bronx, NY 10456
Phone (718) 569-7929

1148 E Tremont Ave
Bronx, NY 10460
Phone 7183783438 ext. 7718

521 W 181st St
New York, NY 10033
Phone (347) 756-6000

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEJIAA

Organizations & group practices 2

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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1598385809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563541",
            "telephone_number": "718-569-7929",
            "fax_number": "203-573-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1262 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563541",
            "telephone_number": "718-569-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELO",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "325566-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.