Individual provider Active NPI

Melanie Bongiovanni, APRN

  • Pediatric Nurse Practitioner
  • Denver, CO
National Provider Identifier
1902573058
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN.1629204 Issued in CO
Practice address
1400 Jackson St
Denver, CO 80206-2762
Phone
(303) 388-4461
Fax
(303) 398-1211
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN.1629204 CO Primary

Addresses

Primary practice location

1400 Jackson St
Denver, CO 80206-2762

Mailing address

1400 Jackson St
Denver, CO 80206-2762
Phone (303) 388-4461

Other practice location 1

500 W Putnam Ave
Greenwich, CT 06830-6086
Phone (475) 240-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231113002247 CO Practitioner - Nurse Practitioner 4688021645 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.1629204COMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
National Jewish Health CurrentSince Oct 2, 2023 Accepting new patients

Locations

1400 Jackson St
Denver, CO 80206
Phone (303) 388-4461

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1902573058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062762",
            "telephone_number": "303-388-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062762",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Putnam Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068306086",
            "country_code": "US",
            "telephone_number": "475-240-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONGIOVANNI",
        "first_name": "MELANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "RN.1629204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.