Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Melissa Diane Mattimore I, RN, ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1710140793

Melissa Diane Mattimore I, RN, ACNP is a Nurse Practitioner in New York, New York. Qualified in 2008, 18 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2008
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.
ACNP — Acute Care Nurse Practitioner
A nurse practitioner who treats acutely ill patients, usually in hospital.

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Practice location Address checks out

1190 5th Ave Box 1458
New York, NY 10029-6503
Phone: (917) 538-2769
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence F430405-1 (NY)

Record details

NPI number1710140793
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN , ACNP
Sole proprietorNo
NPI enumeratedJuly 9, 2008
Last updated in NPPESJanuary 14, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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