Individual provider Active NPI

Melissa Lobel Rose, MD

  • Pediatric Gastroenterology Physician
  • Flushing, NY
National Provider Identifier
1730323031
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
265189 Issued in NY
Practice address
5645 Main St
New York-Presbyterian/Queens
Flushing, NY 11355-5045
Phone
(718) 661-7687
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 265189 NY Primary

Addresses

Primary practice location

5645 Main St
New York-Presbyterian/Queens
Flushing, NY 11355-5045

Mailing address

5645 Main St
New York-Presbyterian/Queens
Flushing, NY 11355-5045

Other practice location 1

19815 Horace Harding Expy
Fresh Meadows, NY 11365-1732
Phone (718) 670-2468

Other practice location 2

505 E 70th St
New York, NY 10021-4872
Phone (646) 962-3869

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address mer9048@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)

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
I20160511000390 NY Practitioner - GastroenterologyPractitioner - Pediatric Medicine 8224327408 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 16, 2023 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell Pediatric Gastroenterology CurrentSince Aug 16, 2023 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

505 E 70th St
Fl 3
New York, NY 10021
Phone (646) 962-3410

505 E 70th St
New York, NY 10021
Phone (212) 746-2900

Networks

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

Interoperability endpoints

  • Direct secure messaging: mer9048@direct.nyp.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1730323031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "address_2": "NEW YORK-PRESBYTERIAN/QUEENS",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "address_2": "NEW YORK-PRESBYTERIAN/QUEENS",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-661-7687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19815 Horace Harding Expy",
            "address_purpose": "LOCATION",
            "city": "Fresh Meadows",
            "state": "NY",
            "postal_code": "113651732",
            "country_code": "US",
            "telephone_number": "718-670-2468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E 70th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214872",
            "country_code": "US",
            "telephone_number": "646-962-3869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MELISSA",
        "middle_name": "LOBEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2024-07-23",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "265189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "505 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mer9048@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging Address",
            "address_1": "5645 Main St",
            "address_2": "New York-Presbyterian/Queens",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "19815 Horace Harding Expy",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113651732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.