Smitha Mellacheruvu
Internal Medicine (Hematology & Oncology)

Address: 111 E 210th St, Hoffheimer 1-- Department of Medical Oncology, Bronx, NY 10467-2401
Phone: 7189204826

Smitha Mellacheruvu (NPI# 1548330970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1548330970
Entity Type Individual
Full Name Smitha Mellacheruvu
Credential MD
Gender Female
Practice Address 111 E 210th St
Hoffheimer 1-- Department of Medical Oncology
Bronx
NY 10467-2401
Practice Telephone 7189204826
Practice Fax Number 7187987474
Mailing Address 39 Grand St
Apt.3210
Mamaroneck
NY 10543-1992
Mailing Telephone 7328891374
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-11-09
Last Update Date 2008-10-08

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207RH0003X Internal Medicine · Hematology & Oncology Allopathic & Osteopathic Physicians 0229985 NY

Physician Overview

NPI 1548330970
PAC ID by PECOS 6800896531
Professional Enrollment ID I20090409000019
Full Name Smitha Mellacheruvu
Organization Legal Name MONTEFIORE MEDICAL CENTER
Phone Number 7189204321
Gender F
Credential MD
Graduation Year 1999
Primary Specialty HEMATOLOGY/ONCOLOGY
Secondary Specialties INTERNAL MEDICINE
Group Practice PAC ID 3779496021
Number of Group Practice Members 1588
Accepts Medicare Assignment M
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330208 ST JOHN'S RIVERSIDE HOSPITAL
330059 MONTEFIORE MEDICAL CENTER
330304 WHITE PLAINS HOSPITAL CENTER

Office Location

Street Address 111 E 210TH ST
HOFFHEIMER 1-- DEPARTMENT OF MEDICAL ONCOLOGY
City BRONX
State NY
Zip Code 10467-2401

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427581040 Kimberly Lynch Student in an Organized Health Care Education/Training Program 111 E 210th St, Bronx, NY 10467-2401 2017-04-10
1255802583 Sukhdeep Kaur Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-12-16
1114497930 Lance Ian Kortesoja Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-12-05
1568932473 Samantha J Cook Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-12-04
1306316351 Swathi Rao Bolneni Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-12-03
1013487149 Melody Zhang Student in an Organized Health Care Education/Training Program 111 E 210th St, Bronx, NY 10467-2401 2018-12-02
1164992574 Ashley S Kim Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-11-28
1134699507 Nina Mae Horodowicz Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-11-28
1043780794 Darius Orhean Pharmacist 111 E 210th St, Bronx, NY 10467-2401 2018-11-26
1558830950 Ronald David Hershcopf Physician Assistant 111 E 210th St, Bronx, NY 10467-2401 2018-11-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1700363108 Danaies Guzman Occupational Therapist 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 2018-07-27
1255853727 Jessica Perkiss Social Worker 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 2017-07-17
1760904494 Walkens Desir Student in an Organized Health Care Education/Training Program 111 East 210th Street Bronx, New York, NY 10467 2017-07-14
1386166221 Erica Santos Licensed Practical Nurse 3273 Parkside Place, Apt 5g, Bronx, NY 10467 2017-07-12
1982125035 Ridin Balakrishnan Student in an Organized Health Care Education/Training Program 111 East 210th Street Bronx, Ny 10467, New York, NY 10467 2017-06-29
1013447341 Grace An Nurse Practitioner 111 E 210th St Fl 2, Bronx, NY 10467 2017-06-19
1710439583 Kj Transportation C Transportation Broker 11 E 213 Sst, Bronx, NY 10467 2016-10-27
1316496128 3210 Webster Ave Prestige Car Service Non-emergency Medical Transport (VAN) 3108 Webster Avenue, Bronx, NY 10467 2016-09-22
1760938062 Gaurav Bhardwaj Student in an Organized Health Care Education/Training Program Montefiore Medical Center 111 East 210th Street, Bronx, NY 10467 2016-08-28
1649628074 Montefiore Medical Center General Acute Care Hospital 110 East 210th St, Bronx, Bronx, NY 10467 2016-05-26
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346321593 Leon C Landau Internal Medicine 75 Gunhill Road, Bronx, NY 10467 2006-10-17
1245311414 Avi I Einzig Internal Medicine 1695 Eastchester Road, Suite 304, Bronx, NY 10461 2006-10-17
1285742379 Petra Rietschel Internal Medicine 1825 Eastchester Road, Rm 2s-55, Bronx, NY 10461 2006-08-28
1043240336 Azriel Hirschfeld Internal Medicine 2330 Eastchester Road, Bronx, NY 10469 2006-07-03
1427095785 Fernando J Camacho Internal Medicine 60 E 208th St, Bronx, NY 10467-2702 2006-06-02
1457315780 Louis Juden Reed Internal Medicine 1180 Morris Park Ave, 3rd Floor, Bronx, NY 10461-1925 2006-04-13
1477516755 Steven E Vogl Internal Medicine 2220 Tiemann Ave, Bronx, NY 10469-6441 2006-04-08
1841289931 Fabio Volterra Internal Medicine 2330 Eastchester Rd, Bronx, NY 10469-5930 2005-10-20
1548653132 Bronx Comprehensive Hematology-oncology, Pllc Internal Medicine 4487 3rd Ave, Fourth Floor, Bronx, NY 10457-1526 2015-03-06
1215282264 Aditya Varnam Shreenivas Internal Medicine 1650 Grand Concourse, Bronx, NY 10457 2012-07-16
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Competitor

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City BRONX
Zip Code 10467

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Dataset Information

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.

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