Individual provider Active NPI

Itay Melamed, MD

  • Neurological Surgery Physician
  • Wilkes Barre, PA
National Provider Identifier
1619078656
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
CP1351 Issued in NE
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 808-6026
Fax
(570) 808-3298
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X CP1351 NE Primary
Surgery Physician 208600000X T2001013358 MO
Neurological Surgery Physician 207T00000X 50908 CO
Neurological Surgery Physician 207T00000X MD458897 PA

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Other practice location 1

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Other practice location 2

11750 W 2nd Pl Ste 255
Lakewood, CO 80228-1726
Phone (303) 643-4117

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imelamed266359@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OK, MD, NE4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170509000055 PA Practitioner - Neurosurgery 8527167527 Reassigns benefits to 1 organization
I20190831000214 OK Practitioner - Neurosurgery 8527167527 Reassigns benefits to 1 organization
I20240327003090 MD Practitioner - Neurosurgery 8527167527 Reassigns benefits to 1 organization
I20250519003162 NE Practitioner - Neurosurgery 8527167527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians
MD West One PCGroup PAC ID 0446228852, shared by 6 NPIs, 89 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

555 S 70TH St
CHI Health St. Elizabeth
Lincoln, NE 68510-2462
Phone (402) 219-8000

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

8005 Farnam Dr
Suite 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50908COMDNeurological Surgery Physician
T2001013358MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince May 15, 2019 Accepting new patients
Geisinger Clinic CurrentSince Feb 18, 2020 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Feb 18, 2020 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Mar 11, 2024 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince May 15, 2019 Accepting new patients
Alegent Creighton Clinic CurrentSince May 1, 2025 Accepting new patients
Major Hospital Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

7710 Mercy Rd
Ste 224
Omaha, NE 68124
Phone (402) 399-8550

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

1000 N Lincoln Blvd
Oklahoma City, OK 73104
Phone (405) 232-8696

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

100 N Academy Ave
Danville, PA 17822

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1619078656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-6026",
            "fax_number": "570-808-3298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8005 Farnam Dr Ste 305",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681143426",
            "country_code": "US",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11750 W 2nd Pl Ste 255",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281726",
            "country_code": "US",
            "telephone_number": "303-643-4117",
            "fax_number": "720-321-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELAMED",
        "first_name": "ITAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NE",
            "license": "CP1351",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "T2001013358",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "50908",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD458897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imelamed266359@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.