Individual provider Active NPI

Melanie Dabakis Degliuomini, M.D.

  • Pediatrics Physician
  • Hackensack, NJ
National Provider Identifier
1992168256
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
239299 Issued in NY
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-5437
NPI assigned
Apr 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA11458500 NJ
Pediatrics Physician 208000000X 239299 NY Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5437

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-5966

Other names 1

  • Dr. Melanie Dabakis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220615002047 NJ Practitioner - Pediatric Medicine 7911386354 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11458500NJMDPediatrics Physician
239299NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Pediatrics CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Pediatrics CurrentSince Jun 1, 2022 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

30 Prospect Ave
Bldg 3RD
Hackensack, NJ 07601
Phone (551) 996-2331

3 Hospital Plz
Ste 206
Old Bridge, NJ 08857
Phone (732) 217-3897

516 Lawrie St
Ste 1
Perth Amboy, NJ 08861

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: melanie.degliuomini@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1992168256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-5966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGLIUOMINI",
        "first_name": "MELANIE",
        "middle_name": "DABAKIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA11458500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "DABAKIS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.