Individual provider Active NPI

Elizabeth Jeanette Melchor, AGPCNP-BC, AGNP-C

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1649011297
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311922 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(646) 445-9906
NPI assigned
Jun 5, 2024
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15158500 NJ
Adult Health Nurse Practitioner 363LA2200X SP031540 PA
Adult Health Nurse Practitioner 363LA2200X 311922 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

525 E 68TH St
New York, NY 10065-4870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250320004083 PA Practitioner - Nurse Practitioner 5496277253 Reassigns benefits to 1 organization
I20251015002162 NY Practitioner - Nurse Practitioner 5496277253 Reassigns benefits to 2 organizations
I20260211003152 NJ Practitioner - Nurse Practitioner 5496277253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

166 Clubhouse Dr
East Stroudsburg, PA 18302-9262

4 HDSN Vly Prof PLZ
Suite B
Newburgh, NY 12550-3157

4055 Valley View LN
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15158500NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 16, 2025 Accepting new patients
Brookview Medical Associates, PLLC Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients
RB Heart and Vascular Care PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 577-7802

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4 Hdsn Vly Prof Plz
Newburgh, NY 12550
Phone (845) 561-3666

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1649011297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-445-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHOR",
        "first_name": "ELIZABETH",
        "middle_name": "JEANETTE",
        "credential": "AGPCNP-BC, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15158500",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP031540",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.