Individual provider Active NPI

Melissa G Perniciaro, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1942033402
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024062528 Issued in NY
Practice address
109 E 115TH St
New York, NY 10029-1186
Phone
(929) 767-0278
Fax
(929) 299-1491
NPI assigned
Aug 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024062528 NY Primary

Addresses

Primary practice location

109 E 115TH St
New York, NY 10029-1186

Mailing address

277 Gold St Apt 4J
Brooklyn, NY 11201-3115
Phone (631) 704-2904

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
I20250307001925 NY Practitioner - Nurse Practitioner 0244751139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024062528NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The New York Foundling Hospital CurrentSince Dec 27, 2024 Accepting new patients
New York Foundling CurrentSince Dec 27, 2024 Accepting new patients
New York Foundling Current Accepting new patients

Locations

170 Brown Pl
Bronx, NY 10454
Phone (212) 206-7140

590 Ave of the Americas
Fl 10
New York, NY 10011

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.

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1942033402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 GOLD ST APT 4J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013115",
            "telephone_number": "631-704-2904",
            "fax_number": "929-299-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291186",
            "telephone_number": "929-767-0278",
            "fax_number": "929-299-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNICIARO",
        "first_name": "MELISSA",
        "middle_name": "G",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-21",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "2024062528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.