Individual provider Active NPI

Melissa Amsellem, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Teaneck, NJ
National Provider Identifier
1760593156
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00163200 Issued in NJ
Practice address
780 Cedar LN
Teaneck, NJ 07666-1706
Phone
(201) 836-7664
Fax
(201) 836-5710
NPI assigned
Aug 31, 2006
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00163200 NJ Primary

Addresses

Primary practice location

780 Cedar LN
Teaneck, NJ 07666-1706

Mailing address

615 McCarthy Dr
New Milford, NJ 07646-1028
Phone (646) 729-8712

Other names 1

  • Melissa Amsellem Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080114000262 NJ Practitioner - Physician Assistant 2769563030 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00163200NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Am PM Primary Care Past Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: melissa.amsellem.1@5622.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1760593156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MCCARTHY DR",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076461028",
            "telephone_number": "646-729-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661706",
            "telephone_number": "201-836-7664",
            "fax_number": "201-836-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSELLEM",
        "first_name": "MELISSA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00163200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "AMSELLEM",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.