Individual provider Active NPI

Amanda Rizzo Walsh, MD, MS

  • Plastic and Reconstructive Surgery Physician
  • Melville, NY
National Provider Identifier
1760045918
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
327612 Issued in NY
Practice address
510 Broadhollow Rd Ste 100
Melville, NY 11747-3606
Phone
(631) 424-3600
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 327612 NY Primary

Addresses

Primary practice location

510 Broadhollow Rd Ste 100
Melville, NY 11747-3606

Mailing address

510 Broadhollow Rd Ste 100
Melville, NY 11747-3606
Phone (631) 424-3600

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
I20260422002937 NY Practitioner - Plastic and Reconstructive Surgery 4587994041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

501 Broadhollow Rd
Suite 100
Melville, NY 11747-3606

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327612NYMDLicensed Practical Nurse

Organizations & group practices 1

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1760045918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BROADHOLLOW RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473606",
            "telephone_number": "631-424-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BROADHOLLOW RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473606",
            "telephone_number": "631-424-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "AMANDA",
        "middle_name": "RIZZO",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "327612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.