Individual provider Active NPI

Melissa A Chism, MD

  • Pediatrics Physician
  • Fair Lawn, NJ
National Provider Identifier
1861459596
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06341000 Issued in NJ
Practice address
20-20 Fair Lawn Ave
Fair Lawn, NJ 07410-2300
Phone
(201) 791-4545
Fax
(201) 791-3709
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06341000NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatricare Associates Pediatrics Past Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
The Valley Hospital Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: melissa.chism@pediatricareassociates.chartmakerdirect.com

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06341000 NJ Primary

Addresses

Primary practice location

20-20 Fair Lawn Ave
Fair Lawn, NJ 07410-2300

Mailing address

20-20 Fair Lawn Ave
Fair Lawn, NJ 07410
Phone (201) 791-4545

Other identifiers 1

IdentifierTypeStateIssuer
7533101MedicaidNJ

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1861459596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20-20 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-4545",
            "fax_number": "201-791-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20-20 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102300",
            "telephone_number": "201-791-4545",
            "fax_number": "201-791-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISM",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06341000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7533101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.