Individual provider Active NPI

Melody Perlberg

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1891045985
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-3000
NPI assigned
Sep 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015811 NY
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

76 Cottonwood LN
Westbury, NY 11590-5743
Phone (516) 439-6885

Other practice location 1

34 S Broadway Ste 504
White Plains, NY 10601-4429
Phone (914) 454-2505

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
I20140113001347 NY Practitioner - Physician Assistant 6103054408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015811NYMDMedical Physician Assistant

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": "1347667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1891045985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 COTTONWOOD LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905743",
            "telephone_number": "516-439-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 S Broadway Ste 504",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106014429",
            "country_code": "US",
            "telephone_number": "914-454-2505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERLBERG",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-15",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015811",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.