Individual provider Active NPI

Melissa M Stilwell, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Media, PA
National Provider Identifier
1609540715
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP024155 Issued in PA
Practice address
1055 E Baltimore Pike Ste 301
Media, PA 19063-5173
Phone
(610) 892-3800
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP024155 PA Primary

Addresses

Primary practice location

1055 E Baltimore Pike Ste 301
Media, PA 19063-5173

Mailing address

1055 E Baltimore Pike Ste 301
Media, PA 19063-5173
Phone (610) 892-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20211012003009 PA Practitioner - Nurse Practitioner 4587062179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Delaware County Professional Services, IncGroup PAC ID 2668436692, 276 clinicians

Practice addresses (Care Compare)

1055 E Baltimore Pike
Media, PA 19063-5173
Phone (610) 892-3800

780 E Market St
West Chester, PA 19382-4882
Phone (610) 892-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP024155PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware County Professional Services, Inc CurrentSince Oct 4, 2021 Accepting new patients

Locations

1055 E Baltimore Pike
Ste 303
Media, PA 19063
Phone (267) 807-3169

1055 E Baltimore Pike
Ste 301
Media, PA 19063
Phone (267) 223-7802

780 E Market St
West Chester, PA 19382
Phone (425) 908-0237

Interoperability endpoints

  • Direct secure messaging: dcp.melissastilwell@141748.advancedmd-direct.com

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1609540715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE STE 301",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE STE 301",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP024155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.