Individual provider Active NPI

Melanie Olga Mendoza-Aguilar, NP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1750065769
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F432648 Issued in NY
Practice address
161 Fort Washington Ave
New York, NY 10032-3729
Phone
(212) 305-7060
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 432648 NY
Acute Care Nurse Practitioner 363LA2100X F432648 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave
New York, NY 10032-3729

Mailing address

309 W 106TH St Apt 5a
New York, NY 10025-3493
Phone (845) 591-4134

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
I20240611002311 NY Practitioner - Nurse Practitioner 8921540519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F432648NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince May 5, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Nurse Practitioner CurrentSince May 5, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Nurse Practitioner Current Accepting new patients

Locations

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

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

Interoperability endpoints

  • Direct secure messaging: mom7021@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1750065769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W 106TH ST APT 5A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253493",
            "telephone_number": "845-591-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA-AGUILAR",
        "first_name": "MELANIE",
        "middle_name": "OLGA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "432648",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.