Melissa Johnnidis, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO4093 Issued in ME

Practice address

66 Bramhall St
Portland, ME 04102-3344

Phone

(207) 662-1310

Fax

(475) 275-7458

NPI assigned

Apr 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Jonathan C Fellers MD PA LLC

  • Multi-Specialty Clinic/Center
  • Portland, ME
  • NPI 1457823817

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761436800000",
    "number": "1336728906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023344",
            "telephone_number": "207-662-1310",
            "fax_number": "207-662-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023344",
            "telephone_number": "207-662-1310",
            "fax_number": "475-275-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNNIDIS",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "DO4093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Psychotherapy LLC
• Jocelyn Delmuro
• Denise Jodoin-Gaidis
• John Stanhope DO
• Liam John, MD
• Malissa Marie Johnsen, CRNA
• Alia Johnson, MD
• Amie Krystrine Johnson, RPH
• Ashley Maureen Johnson, FNP
• Blair Johnson, MHS, PA-C

• Psychiatry Physician in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.