Individual provider Active NPI

Sharon M Melincavage, CRNP

  • Adult Health Nurse Practitioner
  • Pottsville, PA
National Provider Identifier
1639249295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
VP006991C Issued in PA
Practice address
106 S Claude a Lord Blvd
Pottsville, PA 17901-3637
Phone
(570) 622-4209
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X VP006991C PA Primary

Addresses

Primary practice location

106 S Claude a Lord Blvd
Pottsville, PA 17901-3637

Mailing address

5535 Spring Ridge Dr W
Macungie, PA 18062-9569
Phone (570) 617-8230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206000411 PA Practitioner - Nurse Practitioner 1557644143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

700 E Norwegian St
Pottsville, PA 17901-2710
Phone (570) 621-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
VP006991CPAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Feb 1, 2017 Accepting new patients
Integrated Medical Group P C CurrentSince Feb 1, 2017 Accepting new patients
Img Nursing Home Care, P.C. CurrentSince Jul 1, 2020 Accepting new patients
Integrated Medical Group Past Accepting new patients

Locations

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

Interoperability endpoints

  • Direct secure messaging: smelincavage@imgpc.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639249295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 SPRING RIDGE DR W",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180629569",
            "telephone_number": "570-617-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013637",
            "telephone_number": "570-622-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELINCAVAGE",
        "first_name": "SHARON",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "VP006991C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.