Individual provider Active NPI

Alexandra Marie McClellan, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1962107128
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP027718 Issued in PA
Practice address
161 Cecil B Moore Ave Apt 204
Philadelphia, PA 19122-3243
Phone
(215) 585-2144
Fax
(267) 780-7032
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN725016 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP027718 PA Primary
Nurse Practitioner 363L00000X L8-0010697 DE

Addresses

Primary practice location

161 Cecil B Moore Ave Apt 204
Philadelphia, PA 19122-3243

Mailing address

228 Park Ave S Ste 15314
New York, NY 10003-1502
Phone (866) 306-2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230718000540 PA Practitioner - Nurse Practitioner 8325408750 Reassigns benefits to 1 organization
I20240821000991 MD Practitioner - Nurse Practitioner 8325408750 Reassigns benefits to 1 organization
I20240924002104 DE Practitioner - Nurse Practitioner 8325408750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

1644 Annapolis Rd
Suite 4
Odenton, MD 21113-1002
Phone (215) 585-2144

222 Delaware St
Suite 213
Historic New Castle, DE 19720-4855
Phone (215) 585-2144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN725016PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ophelia Medical Group FL, P.a. CurrentSince Jun 14, 2023 Accepting new patients
Ophelia Medical Group, P.C. CurrentSince Apr 9, 2023 Accepting new patients

Locations

1644 Annapolis Rd
Ste 4
Odenton, MD 21113
Phone (240) 743-0343

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

Organizations & group practices 2

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1962107128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PARK AVE S STE 15314",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031502",
            "telephone_number": "866-306-2026",
            "fax_number": "833-228-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CECIL B MOORE AVE APT 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191223243",
            "telephone_number": "215-585-2144",
            "fax_number": "267-780-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN725016",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP027718",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "L8-0010697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.