Individual provider Active NPI

Svetlana Melamed

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1942614896
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
72830 Issued in MN
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

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1942614896MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221213000603 MN Practitioner - Pediatric Medicine 0446542815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-065484ILMDPediatrics Physician
69526WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Oct 17, 2022 Accepting new patients
Childrens Health Care Pediatrics CurrentSince Oct 17, 2022 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.

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

Verify at the official NPI Registry.