Individual provider Active NPI

Melissa M Foye-Petrillo, D.O.

  • Pediatrics Physician
  • Schenectady, NY
National Provider Identifier
1679509947
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
239929 Issued in NY
Practice address
624 McClellan Street
Suite G05
Schenectady, NY 12304-1020
Phone
(518) 347-5113
Fax
(518) 347-5007
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 239929-1 NY
Pediatrics Physician 208000000X 239929 NY Primary

Addresses

Primary practice location

624 McClellan Street
Suite G05
Schenectady, NY 12304-1020

Mailing address

624 McClellan Street
Suite G05
Schenectady, NY 12304-1020
Phone (518) 347-5113

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
I20070719000305 NY Practitioner - Pediatric Medicine 3577664671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239929-1NYMDPediatrics Physician

Organizations & group practices 1

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1679509947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN STREET",
            "address_2": "SUITE G05",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041020",
            "telephone_number": "518-347-5113",
            "fax_number": "518-347-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN STREET",
            "address_2": "SUITE G05",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041020",
            "telephone_number": "518-347-5113",
            "fax_number": "518-347-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOYE-PETRILLO",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239929-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.