Individual provider Active NPI

Melissa Otilia McCarty, PSYD, LP

  • Clinical Neuropsychologist
  • Fridley, MN
National Provider Identifier
1689478745
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
LP7089 Issued in MN
Practice address
520 Osborne Rd NE Ste 210
Fridley, MN 55432-2872
Phone
(763) 236-3800
Fax
(763) 236-3821
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP7089 MN
Clinical Neuropsychologist 103G00000X LP7089 MN Primary

Addresses

Primary practice location

520 Osborne Rd NE Ste 210
Fridley, MN 55432-2872

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other names 1

  • Melissa Otilia Wolfgram Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmccarty636956@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620000584 MN Practitioner - Clinical Psychologist 1759893373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

520 Osborne Rd NE
Suite 210
Fridley, MN 55432-2718
Phone (763) 236-3800

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP7089MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Aug 12, 2025 Accepting new patients
Allina Health System CurrentSince Aug 12, 2025 Accepting new patients
Allina Health System Current Accepting new patients

Locations

520 Osborne Rd NE
Ste 120
Fridley, MN 55432
Phone (763) 236-4300

520 Osborne Rd NE
Ste 210
Fridley, MN 55432
Phone (763) 236-3800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Interoperability endpoints

  • Direct secure messaging: mmccarty636956@excellian.direct.allina.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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1689478745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 OSBORNE RD NE STE 210",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322872",
            "telephone_number": "763-236-3800",
            "fax_number": "763-236-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "MELISSA",
        "middle_name": "OTILIA",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP7089",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP7089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmccarty636956@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "520 Osborne Rd NE Ste 210",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554322872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "WOLFGRAM",
            "middle_name": "OTILIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.