MS. MELLISA DEANDRADE
NPI 1811500028
Nurse Practitioner - Pediatrics in Rye Brook, NY
About Ms. Mellisa Deandrade NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MELLISA DEANDRADE (NPI 1811500028) is an individual pediatrics provider in Rye Brook, New York, licensed in New York (202631228) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Mellisa Deandrade is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mellisa Deandrade reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Port Chester, NY 10573
- Reassigned Medicare billing, New York enrollment
- 149 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10573 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORT CHESTER, NY 10573
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mellisa Deandrade's NPI number?
The NPI number for Mellisa Deandrade is 1811500028. It was assigned to this individual provider in the NPPES registry on August 26, 2020.
Where is Mellisa Deandrade located?
Mellisa Deandrade practices at 113 Bowman Ave, Rye Brook, NY 10573. The listed phone number is (914) 939-1477.
What is Mellisa Deandrade's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Mellisa Deandrade enrolled in Medicare?
Yes. Mellisa Deandrade is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mellisa Deandrade's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mellisa Deandrade reassigns Medicare benefits to Open Door Family Medical Center Inc (Port Chester, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mellisa Deandrade's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mellisa Deandrade was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Mellisa Deandrade · NPI 1811500028
Pediatrics physician in Rye Brook, New York. Individual provider, active in the CMS NPPES registry since August 26, 2020.
## Identity
- **NPI:** 1811500028 (Entity type: Individual)
- **Enumerated:** August 26, 2020
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 202631228 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 113 BOWMAN AVE, Rye Brook, NY 10573-2808
- **Phone:** (914) 939-1477
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Open Door Family Medical Center Inc (NPI 1285893719, Port Chester, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** July 1, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1811500028) · Data from the CMS NPPES public registry.