Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MRS. MELLISA DAWN BLACK PMHNP-BC
NPI 1619673894
Nurse Practitioner - Psychiatric/Mental Health in Saint Louis, MO

Active since January 31, 2023PECOS EnrolledAccepts Medicare Assignment
1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 617-2000 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 9, 2026, Jan 31, 2023 (2 updates tracked since 2023).

About Mrs. Mellisa Dawn Black Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MELLISA DAWN BLACK PMHNP-BC (NPI 1619673894) is an individual psychiatric/mental health provider in Saint Louis, Missouri, licensed in Missouri (2023002795) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Festus, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1619673894
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMRS. MELLISA DAWN BLACKCredential: PMHNP-BC
Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003
Mailing Address1420 Us Highway 61Festus, MO 63028-4108 · (636) 543-2230
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 31, 2023
Last NPPES UpdateJuly 9, 20262 updates tracked since enumeration
NPPES CertifiedJuly 9, 2026
NPI 1619673894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in MO · 2023002795
1465 S GRAND BLVD, Saint Louis, MO 63104

Secondary Practice Location 1

Location 11420 US Highway 61Festus, MO 63028-4108 · Phone (636) 543-2230

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Mellisa Dawn Black Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012381072
PECOS Enrollment IDI20230315001098
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
76 services22 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
58 services23 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
25 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
SAINT LOUIS, MO 63104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mellisa Black's NPI number?

The NPI number for Mellisa Black is 1619673894. It was assigned to this individual provider in the NPPES registry on January 31, 2023.

Where is Mellisa Black located?

Mellisa Black practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 617-2000.

What is Mellisa Black's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mellisa Black enrolled in Medicare?

Yes. Mellisa Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mellisa Black accept?

Health plans from Medica list Mellisa Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mellisa Black was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.