Individual provider Active NPI

Anu Paul Vanmelil

  • Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1801509351
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F310943-01 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone
(631) 233-9421
NPI assigned
Dec 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F310943-01 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-0001

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 233-9421

Other identifiers 1

IdentifierTypeStateIssuer
1801509351MedicaidNY

Other names 1

  • Anu Paul Thomas Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221002654 NY Practitioner - Nurse Practitioner 2163894148 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F310943-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Nov 13, 2023 Accepting new patients

Locations

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

100 Nicolls Rd
Rm 80
Stony Brook, NY 11794
Phone (631) 444-3429

100 Nicolls Rd
Rm 20
Stony Brook, NY 11794
Phone (631) 444-7646

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794
Phone (631) 638-0800

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1801509351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-233-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-233-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANMELIL",
        "first_name": "ANU",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F310943-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801509351",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANU",
            "last_name": "THOMAS",
            "middle_name": "PAUL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.