Individual provider Active NPI

Melissa Madalone, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1720213606
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402830 Issued in NY
Practice address
2315 Victory Blvd
Staten Island, NY 10314-6623
Phone
(718) 477-6900
NPI assigned
May 21, 2009
Last updated
Jul 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 305136 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402830 NY Primary

Addresses

Primary practice location

2315 Victory Blvd
Staten Island, NY 10314-6623

Mailing address

2315 Victory Blvd
Staten Island, NY 10314-6623
Phone (718) 477-6900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000296 NY Practitioner - Nurse Practitioner 6901077791 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

198 Willowbrook Rd
Staten Island, NY 10302-2447
Phone (718) 687-2987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Psychiatric/Mental Health CurrentSince May 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2015 Accepting new patients
Tela-NP in Adult Health and Psychiatric Services PC Adult Health CurrentSince Jan 1, 2020 Accepting new patients
Telanp Online Inc CurrentSince Jan 1, 2020 Accepting new patients

Locations

134 N 4th St
Brooklyn, NY 11249

2315 Victory Blvd
Staten Island, NY 10314
Phone (718) 477-6900

4982 Hylan Blvd
Staten Island, NY 10312
Phone (718) 477-6900

Networks

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

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1720213606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146623",
            "telephone_number": "718-477-6900",
            "fax_number": "718-477-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146623",
            "telephone_number": "718-477-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADALONE",
        "first_name": "MELISSA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305136",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.