Individual provider Active NPI

Melissa Barbara Allen, NP

  • Adult Health Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1225009319
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN 543489 Issued in CA
Practice address
3260 Sacramento St
Berkeley, CA 94702-2739
Phone
(510) 601-6060
Fax
(510) 553-2166
NPI assigned
Jan 28, 2006
Last updated
Mar 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 10100 CA
Adult Health Nurse Practitioner 363LA2200X RN 543489 CA Primary
Gerontology Nurse Practitioner 363LG0600X RN543489 CA
Gerontology Nurse Practitioner 363LG0600X 10100 CA

Addresses

Primary practice location

3260 Sacramento St
Berkeley, CA 94702-2739

Mailing address

3260 Sacramento St
Berkeley, CA 94702-2739
Phone (510) 601-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000915 CA Practitioner - Nurse Practitioner 2062469844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelong Medical CareGroup PAC ID 2062304538, 75 clinicians

Practice addresses (Care Compare)

3260 Sacramento St
Berkeley, CA 94702-2739
Phone (510) 428-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 543489CAMDAdult Health Nurse Practitioner
RN543489CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Feb 22, 2018 Accepting new patients
Lifelong Medical Care CurrentSince Feb 22, 2018 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

3260 Sacramento St
Berkeley, CA 94702
Phone (510) 428-4500

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Interoperability endpoints

  • Direct secure messaging: mallen280406@direct.ochin.org
  • Direct secure messaging: melissa.allen.1@14789.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1225009319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 SACRAMENTO ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947022739",
            "telephone_number": "510-601-6060",
            "fax_number": "510-553-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 SACRAMENTO ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947022739",
            "telephone_number": "510-601-6060",
            "fax_number": "510-553-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MELISSA",
        "middle_name": "BARBARA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "10100",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "RN 543489",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "RN543489",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "10100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.