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MELISSA WALLACE
NPI 1972988640
Social Worker in Bronx, NY

Active since July 23, 2015PECOS Enrolled
579 COURTLANDT AVE, BRONX, NY 10451(718) 485-2100(718) 485-2101 Get Directions Write a Review

NPPES record last updated: July 23, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Melissa Wallace NPPES

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

MELISSA WALLACE (NPI 1972988640) is an individual social worker in Bronx, New York and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972988640
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameMELISSA WALLACE
Location Address579 COURTLANDT AVEBronx, NY 10451-5013
Mailing Address579 Courtlandt AveBronx, NY 10451-5013 · (718) 485-2100 · Fax (718) 485-2101
Phone(718) 485-2100
Fax(718) 485-2101
Sole ProprietorNo
Enumeration DateJuly 23, 2015
✔ NPI 1972988640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
579 COURTLANDT AVE, Bronx, NY 10451
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melissa Wallace 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.

Medicare Billing Reassignment

Medicare enrollment records show Melissa Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York Psychotherapy And Counseling Center
13 mi
Community/Behavioral Health
17620 148TH AVE
Jamaica, NY 11434
  • Reassigned Medicare billing, New York enrollment
  • 249 clinicians in this Medicare group
NPI 1902811342 (718) 553-1100

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 20

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

ILIANA PAOLA MEDINA
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
KELVIN OLIVO
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
MS. RHAZEEL JANGLERI PLATA
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
VANESSA BAEZ
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
MS. JOMAIRA LUZ MARTINEZ LMSW
Social Worker (Clinical)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
RENNY JASMIN RIVERA
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
ASHEA ACEVEDO
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
SARAH JENSEN MHC
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100

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 Melissa Wallace's NPI number?

The NPI number for Melissa Wallace is 1972988640. It was assigned to this individual provider in the NPPES registry on July 23, 2015.

Where is Melissa Wallace located?

Melissa Wallace practices at 579 Courtlandt Ave, Bronx, NY 10451. The listed phone number is (718) 485-2100.

What is Melissa Wallace's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Melissa Wallace enrolled in Medicare?

Yes. Melissa Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Melissa Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melissa Wallace reassigns Medicare benefits to New York Psychotherapy And Counseling Center (Jamaica, 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 Melissa Wallace'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 Melissa Wallace was last updated on July 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.