Mia Myrto McNeil, CRNP, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00756000 Issued in NJ

Practice address

1 Eves Dr Ste 111
Marlton, NJ 08053-3125

Phone

(267) 903-6779

Fax

(267) 933-4189

NPI assigned

Oct 4, 2016

Last updated

Sep 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Myrto Telisma Former name

Medicare fee-for-service enrollment

Enrolled in PA, KS, NJ, FL4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Nurse Practitioner

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Middlesex Psychiatry and TMS PCGroup PAC ID 7315334000, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Middlesex Psychiatry & TMS PC

  dba Reservoir Health

  • Psychiatry Physician
  • Fairfield, NJ
  • NPI 1053971572
  Medicare reassignment Care Compare group NPD
• McNeil Psychiatric Services & Consulting, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
  • NPI 1992566277

  FL

  Medicare reassignment Authorized official
• High Plains Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hays, KS
  • NPI 1710971429
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• McNeil Psychiatric Services & Consulting, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
  • NPI 1386414712
  Authorized official Same address or phone
• Lehigh Valley Physician Group

  dba LVPG General and Bariatric Surgery-1240 Cedar Crest

  • Surgery Physician
  • Allentown, PA
  • NPI 1104195684
  NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1144779067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 111",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "267-903-6779",
            "fax_number": "267-933-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 111",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "267-903-6779",
            "fax_number": "267-933-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEIL",
        "first_name": "MIA",
        "middle_name": "MYRTO",
        "credential": "CRNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP016614",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403472",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00756000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRTO",
            "last_name": "TELISMA",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah McMahon, PA-C
• David McNair
• Kristie Anne McNally, FNP
• McNeil Psychiatric Services & Consulting, LLC
• McNeil Psychiatric Services & Consulting, LLC
• Michele McNulty
• Christa Frances McPhee, MD
• Tracy Lynn McShea, MS,OTR/L
• Kaitlyn McVeigh, MS
• MD Health Clinic LLC

• Psychiatric/Mental Health Nurse Practitioner in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.