MELISSA ANTONOW
NPI 1255837407
Nurse Practitioner - Pediatrics in Commack, NY

Active since April 04, 2018PECOS Enrolled
154 COMMACK RD STE 100, COMMACK, NY 11725(631) 499-8282 Get Directions Write a Review

NPPES record last updated: July 14, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 14, 2022, Jul 7, 2022 (2 updates tracked since 2022).

About Melissa Antonow NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELISSA ANTONOW (NPI 1255837407) is an individual pediatrics provider in Commack, New York, licensed in New York (F382794) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ridgewood.

NPPES Registry Identity

NPI1255837407
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMELISSA ANTONOW
Location Address154 COMMACK RD STE 100Commack, NY 11725-3457
Mailing Address6141 69th PlMiddle Village, NY 11379-1126 · (917) 922-7005 · Fax (917) 922-7005
Sole ProprietorNo
Enumeration DateApril 4, 2018
Last NPPES UpdateJuly 14, 20222 updates tracked since enumeration
NPPES CertifiedJuly 14, 2022
NPI 1255837407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
Licenses Licensed in NY · F382794 Licensed in NY · F3822794-1
Also ListedRegistered NurseTaxonomy 163W00000X · License 631114 (NY)
154 COMMACK RD STE 100, Commack, NY 11725

Secondary Practice Location 1

Location 16655 Fresh Pond RdRidgewood, NY 11385-3261 · Phone (718) 497-1919

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Melissa Antonow is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11725 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Pediatrics)
154 COMMACK RD STE 100
COMMACK, NY 11725

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255837407, enumerated as an "individual" on April 04, 2018.

The provider is located at 154 COMMACK RD STE 100 COMMACK, NY 11725 and the phone number is (631) 499-8282.

Nurse Practitioner with taxonomy code 363LP0200X and a focus in Pediatrics.