Individual provider Active NPI

Melanie Maclennan, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1619176955
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
206178-1 Issued in NY
Practice address
198 E 7TH St Apt 6
New York, NY 10009-5956
Phone
(917) 687-5334
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-01201 NC
Family Medicine Physician 207Q00000X T3025 SC
Family Medicine Physician 207Q00000X 206178-1 NY Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 206178 NY

Addresses

Primary practice location

198 E 7TH St Apt 6
New York, NY 10009-5956

Mailing address

198 E 7TH St Apt 6
New York, NY 10009-5956
Phone (917) 687-5334

Other identifiers 1

IdentifierTypeStateIssuer
2148685MedicaidNY

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
I20100329000642 NY Practitioner - PsychiatryPractitioner - Family PracticePractitioner - Addiction Medicine 0840357448 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine, Family Practice
Education
State University of New York Downstate Medical Center, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4000

8268 164TH St
Jamaica, NY 11432-1121
Phone (718) 883-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-01201NCMDFamily Medicine Physician
206178-1NYMDFamily Medicine Physician
T3025SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. CurrentSince Jun 4, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Long Island Consultation Center CurrentSince Aug 15, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 11, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 11, 2021 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
BRMG-PC Family Medicine Past Accepting new patients
G. S. Mehar Physician, P.C. Past Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: mmaclennan1158839@nychhc.direct-ci.com
  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 10

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 1

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1619176955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 E 7TH ST APT 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095956",
            "telephone_number": "917-687-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E 7TH ST APT 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095956",
            "telephone_number": "917-687-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLENNAN",
        "first_name": "MELANIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "94-01201",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "T3025",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "206178-1",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "206178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2148685",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.