DR. ELLIOT MELENDEZ (NPI# 1417943564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417943564 |
| Entity Type | Individual |
| Full Name | DR. ELLIOT MELENDEZ |
| Credential | M.D. |
| Practice Address |
282 Washington Street Pediatric Intensive Care Unit Hartford CT 06106 |
| Practice Telephone | 8608375455 |
| Practice Fax Number | 7277674970 |
| Mailing Telephone | 8608375455 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
128818 | FL | Allopathic & Osteopathic Physicians |
| N | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
128818 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS | 204942 | 01 |
| MA | BCBS | J25605 | 01 |
| MA | CIGNA-PAL | 7514946 | 01 |
| MA | 0186244 | 05 | |
| MA | UNITED-PBC | 1203129 | 01 |
| MA | AETNA | 3019208 | 01 |
| Street Address |
282 WASHINGTON STREET PEDIATRIC INTENSIVE CARE UNIT |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457812075 | Eugene Michael Master | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Medical Education, 4h, Hartford, CT 06106 | 2019-03-27 |
| 1629500749 | Erin Mcguire Pastor | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ct Children's Medical Center, Hartford, CT 06106 | 2017-03-29 |
| 1700317021 | Jessica Takores | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Medical Education, Hartford, CT 06106 | 2017-03-27 |
| 1356790752 | Mandi L Boisvert | Nurse Practitioner | 282 Washington Street, Hartford, CT 06106 | 2016-06-07 |
| 1326424128 | Amanda Filippelli | Nurse Practitioner | 282 Washington Street, Hartford, CT 06106 | 2015-08-04 |
| 1043607856 | Agnes Reschke | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Medical Education, 4h, Hartford, CT 06106 | 2015-04-20 |
| 1619394152 | Noah Adam Buncher | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Connecticut Children's Medical Center, Hartford, CT 06106 | 2014-03-22 |
| 1770840142 | Jennifer Dorr | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Medical Education, 4h, Hartford, CT 06106 | 2012-04-23 |
| 1881951929 | Laurie Malia | Pediatrics | 282 Washington Street, Medical Education, 4h, Hartford, CT 06106 | 2012-04-13 |
| 1841571981 | Carrie Ann Griffin | Perfusionist | 282 Washington Street, Perfusion Dept - O.r., Hartford, CT 06106-3322 | 2011-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831269729 | Kathy Jean Kalkbrenner | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-11-08 |
| 1033135892 | Adam Silverman | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-07-14 |
| 1508832858 | Aaron Zucker | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-27 |
| 1457325805 | Daniel G. Fisher | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-14 |
| 1538132055 | Christopher Carroll | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-08 |
| 1407828197 | Leonard Comeau | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477088235 | Marie Nader | Pediatrics | 20 York St, New Haven, CT 06510-3220 | 2017-04-28 |
| 1821338377 | Samira Neshat Vahid | Pediatrics | 20 York St, Tompkins 209, New Haven, CT 06510-3220 | 2013-02-20 |
| 1093073959 | Nina N. Brodsky | Pediatrics | 20 York St, Ynhh Department of Pediatrics, New Haven, CT 06510-3220 | 2012-04-30 |
| 1306116389 | Jose Manuel Panisello | Pediatrics | 20 York St, 305 Lci, New Haven, CT 06510-3220 | 2012-01-06 |
| 1538397450 | Engin Deniz | Pediatrics | 20 York St, T-209 Yale New Haven Hospital, New Haven, CT 06510-3220 | 2009-06-30 |
| 1700029238 | Michael Clinton Hooper | Pediatrics | 333 Cedar St, New Haven, CT 06510-3206 | 2009-04-14 |
| 1407867096 | Troy E Dominguez | Pediatrics | 15 York St, New Haven, CT 06510-3221 | 2006-08-10 |
| 1821023433 | Vicki Smetak | Pediatrics | 24 Stevens St, Norwalk, CT 06850-3852 | 2006-07-11 |
| 1588604052 | Mustafa Kezar Khokha | Pediatrics | 800 Howard Ave, Yale Physicians Bldg, New Haven, CT 06519-1369 | 2006-06-06 |
| 1487609756 | Stephanie Sudikoff | Pediatrics | 333 Cedar St, Pediatrics/yale University, New Haven, CT 06510-3206 | 2006-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.