Individual provider Active NPI

Melanie Ann Van Sise, M.D.

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Setauket, NY
National Provider Identifier
1629392121
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X
License
274136 Issued in NY
Practice address
200 Main St
Suite 2
Setauket, NY 11733
Phone
(631) 751-9595
Fax
(631) 751-2322
NPI assigned
Mar 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician 207VH0002X 274136 NY Primary

Addresses

Primary practice location

200 Main St
Suite 2
Setauket, NY 11733

Mailing address

45 Research Way Ste 105
East Setauket, NY 11733-6401
Phone (631) 675-2125

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
I20160502000173 NY Practitioner - Obstetrics/Gynecology 7810296571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8091
Phone (631) 444-7650

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-4686

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P CurrentSince Jul 1, 2018 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

333 Route 25A
Ste 30
Rocky Point, NY 11778
Phone (631) 821-4444

200 Main St
Ste 2
Setauket, NY 11733
Phone (631) 751-9494

200 Main St
Ste 6
Setauket, NY 11733
Phone (631) 751-7676

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: melanie.vansise@sbcm.cernerdirect.com

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.

Hospital & facility affiliations 7

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": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1629392121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 105",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "address_2": "SUITE 2",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-751-9595",
            "fax_number": "631-751-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SISE",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "274136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.