Individual provider Active NPI

Melissa A Tanner, PH.D.

  • Clinical Psychologist
  • Brooklandville, MD
National Provider Identifier
1235564139
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05109 Issued in MD
Practice address
10807 Falls Rd
#1419
Brooklandville, MD 21022-7500
Phone
(410) 802-1462
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05109 MD Primary

Addresses

Primary practice location

10807 Falls Rd
#1419
Brooklandville, MD 21022-7500

Mailing address

6628 Charlesway
Towson, MD 21204-6823
Phone (410) 707-3403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131220001322 MD Practitioner - Clinical Psychologist 1557598414 Reassigns benefits to 1 organization
I20150112001466 DC Practitioner - Clinical Psychologist 1557598414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Della Behavioral Health ServicesGroup PAC ID 3971755000, 54 clinicians

Practice addresses (Care Compare)

16940 Georgia Ave
Olney, MD 20832-2424
Phone (410) 929-7225

7067 Columbia Gateway Dr
Suite 180
Columbia, MD 21046-3408

9841 Broken Land Pkwy
Suite 314
Columbia, MD 21046-3078
Phone (410) 929-7225

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Quality
75.8
Improvement activities
40
Cost
77.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05109MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Della Behavioral Health Services CurrentSince Sep 25, 2013 Accepting new patients

Locations

10807 Falls Rd
Unit 1419
Brooklandville, MD 21022
Phone (410) 802-1462

9841 Broken Land Pkwy
Ste 314
Columbia, MD 21046
Phone (410) 929-7225

7067 Columbia Gateway Dr
Ste 180
Columbia, MD 21046
Phone (410) 925-7225

Organizations & group practices 1

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1235564139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 CHARLESWAY",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046823",
            "telephone_number": "410-707-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 FALLS RD",
            "address_2": "#1419",
            "city": "BROOKLANDVILLE",
            "state": "MD",
            "postal_code": "210227500",
            "telephone_number": "410-802-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklandville, MD

Sources for this page

Verify at the official NPI Registry.