Individual provider Active NPI

Melissa Andriani Rusli, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1770978165
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
287872 Issued in NY
Practice address
505 E 70TH St
New York, NY 10021
Phone
(212) 746-3587
Fax
(212) 746-8051
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 287872 NY Primary

Addresses

Primary practice location

505 E 70TH St
New York, NY 10021

Mailing address

505 E 70TH St HT-4
New York, NY 10021-4872
Phone (212) 746-5856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180727001893 NY Practitioner - Internal Medicine 3173870730 Reassigns benefits to 3 organizations
I20210913003638 FL Practitioner - Internal Medicine 3173870730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

300 Parkview PL
Lakeland, FL 33805-4550
Phone (863) 687-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Internal Medicine CurrentSince Jun 26, 2018 Accepting new patients
Weill Medical College of Cornell Internal Medicine Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jun 26, 2018 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Sep 9, 2021 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 2, 2018 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

300 Parkview Pl
Lakeland, FL 33805
Phone (863) 687-1300

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

1305 York Ave
Fl 8
New York, NY 10021
Phone (646) 962-3176

1300 York Ave
New York, NY 10065
Phone (212) 746-2900

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

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
#J314
New York, NY 10065
Phone (212) 746-4158

505 E 70th St
#4
New York, NY 10021
Phone (212) 746-2900

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 8

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.

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1770978165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST HT-4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-5856",
            "fax_number": "212-746-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-746-3587",
            "fax_number": "212-746-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSLI",
        "first_name": "MELISSA",
        "middle_name": "ANDRIANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "287872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.