Active NPI
Melissa Anne Maxwell, PMHNP - BC
- Psychiatric/Mental Health Nurse Practitioner
- San Francisco, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 71009757B
- Practice address
- 490 Post St Ste 1043
San Francisco, CA 94102-1301 - Phone
- (925) 282-1778
- Fax
- (415) 296-5299
- NPI assigned
- Nov 15, 2019
- Last updated
- Nov 3, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 28200431A | IN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95013526 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71009757B | IN | Primary |
Addresses
Primary practice location
490 Post St Ste 1043
San Francisco, CA 94102-1301
Mailing address
490 Post St Ste 1043
San Francisco, CA 94102-1301
Phone (925) 282-1778
Other practice location 1
7300 E Indiana St
Evansville, IN 47715-7448
Phone (812) 401-8008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2365 Iron Point Rd
Suite 210
Folsom, CA 95630-8713
Phone (925) 282-1778
7300 E Indiana St
Suite 103
Evansville, IN 47715-7448
Phone (812) 401-8008
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28200431A | IN | MD | Nurse Practitioner |
| 71009757B | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Current | Accepting new patients | |
| Midwest Behavioral Health LLC | Current | Accepting new patients | |
| Brentwood Meadows Physician Group LLC | Psychiatric/Mental Health | Current | Accepting new patients |
Locations
1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292
2365 Iron Point Rd
Ste 210
Folsom, CA 95630
Phone (925) 360-5264
490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944
7300 E Indiana St
Ste 103
Evansville, IN 47715
Phone (812) 401-8008
10967 Allisonville Rd
Ste 240
Fishers, IN 46038
Phone (317) 436-1222
4488 Roslin Rd
Newburgh, IN 47630
Phone (812) 710-4038
Interoperability endpoints
- lifestancehealth.melissamaxwell@148377.advancedmd-direct.com
- mbh.melissamaxwell@140099.advancedmd-direct.com
Organizations & group practices 3
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.
-
dba dba LifeStance Health
- Psychiatry Physician
- Evansville, IN
- NPI 1427362201
-
dba Lifestance Health
- Clinical Psychologist
- Scottsdale, AZ
- NPI 1023125465
CA
-
- Psychiatry Physician
- Newburgh, IN
- NPI 1528479029
Psychiatric/Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730592000000",
"number": "1518502319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 POST ST STE 1043",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941021301",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 POST ST STE 1043",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941021301",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
}
],
"practiceLocations": [
{
"address_1": "7300 E Indiana St",
"address_purpose": "LOCATION",
"city": "Evansville",
"state": "IN",
"postal_code": "477157448",
"country_code": "US",
"telephone_number": "812-401-8008",
"fax_number": "812-401-8201",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAXWELL",
"first_name": "MELISSA",
"middle_name": "ANNE",
"credential": "PMHNP - BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-15",
"last_updated": "2024-11-03",
"certification_date": "2024-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "28200431A",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95013526",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IN",
"license": "71009757B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.