Active NPI
Jennifer Alyssa Maclean, NP
- Nurse Practitioner
- Palo Alto, CA
National Provider Identifier
1235565177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95009392
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8000
- NPI assigned
- Sep 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 18499 | SC | |
| Nurse Practitioner | 363L00000X | 95009392 | CA | Primary |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other practice location 1
200 Patewood Dr
Ste A330
Greenville, SC 29615-3593
Phone (864) 454-5660
Other practice location 2
200 Patewood Dr Ste A330
Greenville, SC 29615-3593
Phone (864) 454-5660
Other practice location 3
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-2471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP2560 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18499 | SC | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1235565177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
}
],
"practiceLocations": [
{
"address_1": "200 Patewood Dr",
"address_2": "Ste A330",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296153593",
"country_code": "US",
"telephone_number": "864-454-5660",
"fax_number": "864-454-5665",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Patewood Dr Ste A330",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296153593",
"country_code": "US",
"telephone_number": "864-454-5660",
"fax_number": "864-454-5665",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4650 W Sunset Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900276062",
"country_code": "US",
"telephone_number": "323-361-2471",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACLEAN",
"first_name": "JENNIFER",
"middle_name": "ALYSSA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-24",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "SC",
"license": "18499",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95009392",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP2560",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.