Mrs Melba Paulose, NP is a medicare enrolled "Nurse Practitioner - Gerontology" in Hollis, Queens, New York. Her current practice location is
194-44 Woodhull Ave, Hollis, Queens, New York. You can reach out to her office (for appointments etc.) via phone at
(516) 967-3681.
Mrs Melba Paulose is licensed to practice in New York (license number F310011-01) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578222972.
Provider's Profile
| Full Name | Mrs Melba Paulose |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Gerontology |
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| Location | 194-44 Woodhull Ave, Hollis, Queens, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578222972
- Provider Enumeration Date: 12/13/2021
- Last Update Date: 12/13/2021
Medicare PECOS Information:
- PECOS PAC ID: 5294127478
- Enrollment ID: I20220120000850
Medical Identifiers
Medical identifiers for Mrs Melba Paulose such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578222972 | NPI | - | NPPES |
| F310011-01 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LG0600X | Nurse Practitioner - Gerontology | F310011-01 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Melba Paulose allows following entities to bill medicare on her behalf.
| Entity Name | Samaritan Medical Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124184544
PECOS PAC ID: 7012016009
Enrollment ID: O20070727000051 |
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| Entity Name | Medical Director Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871955807
PECOS PAC ID: 0042501116
Enrollment ID: O20160621000218 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Melba Paulose is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Melba Paulose, NP
17 5th Pl,
Syosset, NY 11791-3605
Ph: (516) 967-3681 | Mrs Melba Paulose, NP
194-44 Woodhull Ave,
Hollis, Queens, NY 11423
Ph: (516) 967-3681 |
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