Melissa Diane Mattimore I, RN, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

F430405-1 Issued in NY

Practice address

1190 5TH Ave
Box 1458
New York, NY 10029-6503

Phone

(917) 538-2769

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: melissamattimore@nslijmedgr.allscriptsdirect.net

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1710140793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE",
            "address_2": "BOX 1458",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "917-538-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE",
            "address_2": "BOX 1458",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "917-538-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIMORE",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "name_suffix": "I",
        "credential": "RN, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430405-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Matthews
• Sophie Matthews
• Julia Matthias, MD
• Willie J Matthias, CASAC
• Daniel E. Mattila, LCSW
• Sara Mattina, MSW
• James Lee Mattingly, CRNA
• Shameeka Mattis
• Bailey Mattison
• Juno Jessica Wendell Mattiuzzi

• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.