Melissa Tully, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00755400 Issued in NJ

Practice address

60 Skyline Dr
Ringwood, NJ 07456-2039

Phone

(973) 962-4000

NPI assigned

Oct 26, 2017

Last updated

Oct 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1710499017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BEAN CT",
            "city": "WANAQUE",
            "state": "NJ",
            "postal_code": "074651001",
            "telephone_number": "973-207-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SKYLINE DR",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562039",
            "telephone_number": "973-962-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00755400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Tanis, DC
• The Devereux Foundation (Devereux Advanced Behavioral Health)
• The Rasa Group Inc.
• Janice Thorson
• Fernando Tordoya, D.D.S.
• Mary Ann Tuohy, LPC
• Caitlyn Undreiner
• Elizabeth Anne Voight, OTR
• Donna Volpe, MA CCC-SLP
• Suzanne Michelle Wiley, MA, CCC-SLP

• Adult Health Nurse Practitioner in Ringwood, NJ
• Providers in Ringwood, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.