Melissa Jane Petty, NP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

CNP-03454 Issued in NM

Practice address

3917 West Rd
Los Alamos, NM 87544-2275

Phone

(505) 661-9230

NPI assigned

Apr 7, 2006

Sex

Female

Sole proprietor

No

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.

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  NPD
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD
• Los Alamos Physician Practices LLC

  • Family Medicine Physician
  • Los Alamos, NM
  • NPI 1750330510

  Nurse Practitioner

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dxs6413@yourcarecommunity.org

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1790748168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7029 CAMINO ROJO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073533",
            "telephone_number": "254-760-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NM",
            "license": "CNP-03454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "500008494",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292880-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "82N617",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Usha Panthi, FNP-C
• Roberto C. Pardo, AGPNP
• Sara Pasqualoni
• Anne Elizabeth Peick, NP
• Elisabeth Scherf Perry, PH.D.
• PHC- Los Alamos Inc
• PHC-Los Alamos Inc
• PHC-Los Alamos Inc
• PHC-Los Alamos Inc
• Physical Therapy Plus Inc

• All providers in Los Alamos, NM
• Neonatal Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.