Individual provider Active NPI

Melissa Ashley Fengler, NP

  • Adult Health Nurse Practitioner
  • West Islip, NY
National Provider Identifier
1881034858
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306510 Issued in NY
Practice address
540 Union Blvd
West Islip, NY 11795-3105
Phone
(631) 669-2555
NPI assigned
Jul 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 585449-1 NY
Adult Health Nurse Practitioner 363LA2200X 306510 NY Primary

Addresses

Primary practice location

540 Union Blvd
West Islip, NY 11795-3105

Mailing address

364 Oakwood Ave
West Islip, NY 11795-2913
Phone (631) 680-0359

Other names 1

  • Melissa Ashley Palomba Former 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
I20140725000532 NY Practitioner - Nurse Practitioner 5395961452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
585449-1NYMDRegistered Nurse
306510NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Dec 16, 2019 Accepting new patients
North Shore-Lij Medical PC CurrentSince Dec 16, 2019 Accepting new patients
St. Francis Hospital CurrentSince Jan 30, 2014 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

39 Brentwood Rd
Ste 101
Bay Shore, NY 11706
Phone (631) 590-7400

300 Community Dr
Plandome, NY 11030

540 Union Blvd
West Islip, NY 11795
Phone (631) 669-2555

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Interoperability endpoints

  • Direct secure messaging: mfengler28313@direct-chsli.net

Organizations & group practices 5

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": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1881034858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 OAKWOOD AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952913",
            "telephone_number": "631-680-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953105",
            "telephone_number": "631-669-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENGLER",
        "first_name": "MELISSA",
        "middle_name": "ASHLEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "585449-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PALOMBA",
            "middle_name": "ASHLEY",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.