Individual provider Active NPI

Melissa Jane Sharp, PSY.D.

  • Specialist
  • St Charles, IL
National Provider Identifier
1174530497
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
071006672 Issued in IL
Practice address
1434 E Main St
Ste B
St Charles, IL 60174
Phone
(630) 777-6333
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 071006672 IL Primary

Addresses

Primary practice location

1434 E Main St
Ste B
St Charles, IL 60174

Mailing address

1434 E Main St
Ste B
St Charles, IL 60174
Phone (630) 777-6333

Other identifiers 4

IdentifierTypeStateIssuer
9341323OtherILPHCS
733951000OtherILMAGELLAN
7715574OtherILAETNA
4532172OtherILBLUE CROSS / BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924001075 IL Practitioner - Clinical Psychologist 7012986250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1434 E Main St
Suite B
Saint Charles, IL 60174-2374
Phone (630) 777-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Melissa Sharp and Associates LTD CurrentSince Mar 19, 2004 Accepting new patients
Jill Levinsky Psy.D. P.C. PastSince Dec 12, 2010 Accepting new patients

Locations

1434 E Main St
Ste B
St Charles, IL 60174
Phone (331) 222-7915

1121 E Main St
Ste 126
St Charles, IL 60174
Phone (630) 777-6333

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1174530497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 E MAIN ST",
            "address_2": "STE B",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-777-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 E MAIN ST",
            "address_2": "STE B",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-777-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "071006672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9341323",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "733951000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7715574",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "4532172",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.