DONNA MELLE CNM NPI 1003021866

Nurse Practitioner in Galloway, NJ

Individual Female Years of Experience 28 Nurse Practitioner PECOS Enrolled Accepts Medicare Approved Payment

About DONNA MELLE CNM

Donna Melle is a provider established in Galloway, New Jersey and her medical specialization is Nurse Practitioner with more than 28 years of experience. The NPI number of Donna Melle is 1003021866 and was assigned on May 2007. The practitioner's primary taxonomy code is 363L00000X with license number 26NO07205500 (NJ). The provider is registered as an individual and her NPI record was last updated 2 years ago.

A nurse practitioner (NP) like Donna Melle Cnm is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

NPI

1003021866

Provider Name DONNA MELLE CNM
Provider Location Address65 W JIMMIE LEEDS RD GALLOWAY, NJ 08205
Provider Mailing Address10 GREENTREE CT EGG HARBOR TOWNSHIP, NJ 08234
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1995
Is Sole Proprietor?No
Enumeration Date05-14-2007
Last Update Date01-26-2021



Donna Melle is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

Donna Melle is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.6 for a new patient copayment and $28.36 for an established patient copayment.



Primary Taxonomy

Taxonomy Code363L00000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.26NO07205500
License StateNJ
Taxonomy Description(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Business Address

DONNA MELLE CNM
65 W JIMMIE LEEDS RD
GALLOWAY, NJ
ZIP 08205
Phone: (609) 404-3830

Get Directions


Mailing Address

DONNA MELLE CNM
10 GREENTREE CT
EGG HARBOR TOWNSHIP, NJ
ZIP 08234
Phone: (609) 432-5455


Secondary Locations

10 Greentree Ct
Egg Harbor Township, NJ 08234
(609) 432-5455
443 Shore Rd Ste 101
Somers Point, NJ 08244
(609) 569-7830
1401 Atlantic Ave Ste 2300
Atlantic City, NJ 08401
(609) 404-3830

PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID4082844022
PECOS Enrollment IDI20140313000428
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)No
Eligible order / refer Power Mobility DevicesNo

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 08205 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$64.36 $193.06 $98.42
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.09 $48.26 $24.6
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$20.44 $158.01 $113.47
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.11 $39.5 $28.36

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 47Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • 39Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife25ME00027001NJNo

Taxonomy Description: midwifery practice as conducted by certified nurse-midwives (CNMs) and certified midwives (CMs) is the independent management of women's health care, focusing particularly on pregnancy, childbirth, the post partum period, care of the newborn, and the family planning and gynecologic needs of women. The CNM and CM practice within a health care system that provides for consultation, collaborative management, or referral, as indicated by the health status of the client. CNMs and CMs practice in accord with the Standards for the Practice of Midwifery, as defined by the American College of Nurse-Midwives (ACNM).

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003021866
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003022812
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 2 + 8 + 1 + 2 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003021866 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1730429085 RUTH MARY HACKNEY RPH
Individual
Pharmacist65 W JIMMIE LEEDS RD
GALLOWAY, NJ 08205
(609) 652-3489
1457779852DR. JOSEPH ANTHONY ASARO JR. D.O.
Individual
Pediatrics (Neonatal-Perinatal Medicine)65 W JIMMIE LEEDS RD
GALLOWAY, NJ 08205
(609) 652-1000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Donna Melle Cnm is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.