Individual provider Active NPI

Nickesha Melville

  • Medical-Surgical Registered Nurse
  • Long Island City, NY
National Provider Identifier
1831995174
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
934376 Issued in NY
Practice address
2811 Queens PLZ N
Long Island City, NY 11101-4172
Phone
(718) 391-8300
NPI assigned
Feb 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 934376 NY Primary

Addresses

Primary practice location

2811 Queens PLZ N
Long Island City, NY 11101-4172

Mailing address

3400 Snyder Ave Apt 3K
Brooklyn, NY 11203-3937

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
934376NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1831995174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SNYDER AVE APT 3K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 QUEENS PLZ N",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014172",
            "telephone_number": "718-391-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "NICKESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "934376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.