Individual provider Active NPI

Melissa Regan, PA-C

  • Physician Assistant
  • Joppa, MD
National Provider Identifier
1366116501
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1415 S Mountain Rd Ste 100
Joppa, MD 21085-3236
Phone
(410) 918-0777
NPI assigned
Aug 2, 2021
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1415 S Mountain Rd Ste 100
Joppa, MD 21085-3236

Mailing address

1415 S Mountain Rd Ste 100
Joppa, MD 21085-3236
Phone (410) 918-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20230817002939 MD Practitioner - Physician Assistant 1153783402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544

22 S Greene Stre
Med Ctr GCRC Office
Baltimore, MD 21201-1544
Phone (410) 328-7877

827 Linden Ave
Baltimore, MD 21201-4606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians P.a. CurrentSince Sep 11, 2023 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Sep 11, 2023 Accepting new patients
Medical Health Group PA Current Accepting new patients
Medical Health Group, PA Current Accepting new patients
University of Maryland Physicians P.a. Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

1415 S Mountain Rd
#100
Joppa, MD 21085
Phone (410) 918-0777

Interoperability endpoints

  • Direct secure messaging: mregan800217@direct.umm.edu

Organizations & group practices 5

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1366116501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 S MOUNTAIN RD STE 100",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853236",
            "telephone_number": "410-918-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 S MOUNTAIN RD STE 100",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853236",
            "telephone_number": "410-918-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2023-01-24",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joppa, MD

Sources for this page

Verify at the official NPI Registry.