Individual provider Active NPI

Maksim Melnikov

  • Licensed Practical Nurse
  • Jamaica, NY
National Provider Identifier
1831588508
Registry record updated Jan 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
315466-1 Issued in NY
Practice address
8451 Lander St
Jamaica, NY 11435-2020
Phone
(718) 708-9837
NPI assigned
Jan 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 315466-1 NY Primary

Addresses

Primary practice location

8451 Lander St
Jamaica, NY 11435-2020

Mailing address

8451 Lander St
Jamaica, NY 11435-2020
Phone (718) 708-9837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
315466-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1421452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421452800000",
    "number": "1831588508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 LANDER ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114352020",
            "telephone_number": "718-708-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 LANDER ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114352020",
            "telephone_number": "718-708-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELNIKOV",
        "first_name": "MAKSIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-17",
        "last_updated": "2015-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "315466-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.