Active NPI
Svetlana Melamed
- Pediatrics Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 72830
- Practice address
- 2525 Chicago Ave
Minneapolis, MN 55404-4518 - Phone
- (612) 813-6000
- NPI assigned
- Jun 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125-065484 | IL | |
| Pediatrics Physician | 208000000X | 69526 | WI | |
| Pediatrics Physician | 208000000X | 72830 | MN | Primary |
Addresses
Primary practice location
2525 Chicago Ave
Minneapolis, MN 55404-4518
Mailing address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Other practice location 1
3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-3380
Other practice location 2
9000 W Wisconsin Ave
Milwaukee, WI 53226
Phone (414) 337-7050
Other practice location 3
345 Smith Ave N
Saint Paul, MN 55102-2346
Phone (651) 220-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942614896 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-065484 | IL | MD | Pediatrics Physician |
| 69526 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care | Current | Accepting new patients | |
| Childrens Health Care | Pediatrics | Current | Accepting new patients |
Locations
2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000
5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691
347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000
345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Minneapolis, MN
- NPI 1932208808
-
- Children's Hospital
- Minneapolis, MN
- NPI 1881793750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1942614896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044518",
"telephone_number": "612-813-6000"
}
],
"practiceLocations": [
{
"address_1": "3801 Spring St",
"address_purpose": "LOCATION",
"city": "Mount Pleasant",
"state": "WI",
"postal_code": "534051667",
"country_code": "US",
"telephone_number": "262-687-3380",
"fax_number": "262-687-5358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9000 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "53226",
"country_code": "US",
"telephone_number": "414-337-7050",
"fax_number": "414-337-7020",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "345 Smith Ave N",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551022346",
"country_code": "US",
"telephone_number": "651-220-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MELAMED",
"first_name": "SVETLANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-19",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125-065484",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "69526",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "72830",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942614896",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.