Individual provider Active NPI

Melatid T Haimanot, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1750629630
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
310432 Issued in NY
Practice address
41 Green Knolls Dr
Apt. a
Rochester, NY 14620-4767
Phone
(585) 352-6961
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 310432 NY Primary

Addresses

Primary practice location

41 Green Knolls Dr
Apt. a
Rochester, NY 14620-4767

Mailing address

41 Green Knolls Dr
Apt. a
Rochester, NY 14620-4767
Phone (585) 352-6961

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
310432NYMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1750629630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GREEN KNOLLS DR",
            "address_2": "APT. A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204767",
            "telephone_number": "585-352-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 GREEN KNOLLS DR",
            "address_2": "APT. A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204767",
            "telephone_number": "585-352-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIMANOT",
        "first_name": "MELATID",
        "middle_name": "T",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "310432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.