Individual provider Active NPI

Melissa Costanza Sallah, DC

  • Chiropractor
  • Massapequa, NY
National Provider Identifier
1730106246
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010450 Issued in NY
Practice address
4200 Sunrise Hwy
Massapequa, NY 11758-5311
Phone
(631) 332-9089
Fax
(516) 798-9070
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010450 NY Primary

Addresses

Primary practice location

4200 Sunrise Hwy
Massapequa, NY 11758-5311

Mailing address

4200 Sunrise Hwy
Massapequa, NY 11758-5311
Phone (631) 332-9089

Other practice location 1

112 South Country Road
Suite 103
Bellport, NY 11713
Phone (631) 286-9410

Other names 1

  • Dr. Melissa Costanza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010450NYMDCounselor
X010450NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Claudia Taylor DC PC Past Accepting new patients
Bellport Chiropractic, P.C. Chiropractor PastSince May 23, 2008 Accepting new patients

Organizations & group practices 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1730106246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585311",
            "telephone_number": "631-332-9089",
            "fax_number": "516-798-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585311",
            "telephone_number": "631-332-9089",
            "fax_number": "516-798-9070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 South Country Road",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Bellport",
            "state": "NY",
            "postal_code": "11713",
            "country_code": "US",
            "telephone_number": "631-286-9410",
            "fax_number": "631-286-6491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALLAH",
        "first_name": "MELISSA",
        "middle_name": "COSTANZA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "COSTANZA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.