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MELODIE BACK LMHC
NPI 1952858920
Counselor - Mental Health in Flushing, NY

Active since September 07, 2016PECOS EnrolledAccepts Medicare Assignment
9701 NORTHERN BLVD, FLUSHING, NY 11368(718) 765-6053(347) 706-3810 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 4, 2025, Jun 6, 2025 (2 updates tracked since 2025).

About Melodie Back Lmhc NPPES

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

MELODIE BACK LMHC (NPI 1952858920) is an individual mental health provider in Flushing, New York, licensed in New York (008743) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Jamaica, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1952858920
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMELODIE BACKCredential: LMHC
Location Address9701 NORTHERN BLVDFlushing, NY 11368-1043
Mailing AddressPo Box 746087Atlanta, GA 30374-6087 · (312) 733-9730
Phone(718) 765-6053
Fax(347) 706-3810
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateSeptember 7, 2016
Last NPPES UpdateNovember 4, 20252 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
✔ NPI 1952858920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 008743
9701 NORTHERN BLVD, Flushing, NY 11368
Open in Google Maps ↗

Secondary Practice Location 1

Location 110504 Sutphin BlvdJamaica, NY 11435-5022 · Phone (844) 400-1975

Other Identifiers 1

Medicaid2997620NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Melodie Back Lmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214479906
PECOS Enrollment IDI20240610002110
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Melodie Back reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oak Street Health Of New York Medical Group PC
6.4 mi
Primary Care
455 SUTTER AVE
Brooklyn, NY 11212
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Griffin Myers Medical PC
  • 101 clinicians in this Medicare group
NPI 1780209445 (718) 765-6550
Sun River Health Inc
6.5 mi
Adult Day Care
1543-1545 INWOOD AVENUE, HUDSON RIVER HEALTHCARE ADULT DAY PROGRAM
Bronx, NY 10452
  • Reassigned Medicare billing, New York enrollment
  • 683 clinicians in this Medicare group
NPI 1740763275 (855) 681-8700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

FATIMA Y GIRON RIVAS MD
Family Medicine
9701 NORTHERN BLVD
FLUSHING, NY 11368
Queens County (718) 765-6053
MS. DARA KARMEL WINFIELD CRNP
Nurse Practitioner (Family)
9701 NORTHERN BLVD
FLUSHING, NY 11368
Queens County (718) 765-6053
TANYA J KAPKA MD
Family Medicine
9701 NORTHERN BLVD
FLUSHING, NY 11368
Queens County (718) 765-6053
MRS. NATASHA JULYMARIE CARRASQUILLO GUADALUPE MD
Internal Medicine
9701 NORTHERN BLVD
FLUSHING, NY 11368
Queens County (718) 765-6053
TENZING CHOUNZOM MD
Internal Medicine
9701 NORTHERN BLVD
FLUSHING, NY 11368
Queens County (718) 765-6053

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 Melodie Back's NPI number?

The NPI number for Melodie Back is 1952858920. It was assigned to this individual provider in the NPPES registry on September 7, 2016.

Where is Melodie Back located?

Melodie Back practices at 9701 Northern Blvd, Flushing, NY 11368. The listed phone number is (718) 765-6053.

What is Melodie Back's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Melodie Back enrolled in Medicare?

Yes. Melodie Back is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Melodie Back's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melodie Back reassigns Medicare benefits to 2 organizations: Oak Street Health Of New York Medical Group PC (Brooklyn, NY) and Sun River Health Inc (Bronx, NY). Each 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 Melodie Back'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 Melodie Back was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.