MERLENE T RICHARDSON FNP-BC
NPI 1154081602
Nurse Practitioner - Family in Gary, IN

Active since December 26, 2021PECOS EnrolledAccepts Medicare Assignment
74.63/100
CMS Quality Rating

NPPES record last updated: March 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Merlene T Richardson Fnp-bc NPPES

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

MERLENE T RICHARDSON FNP-BC (NPI 1154081602) is an individual family provider in Gary, Indiana, licensed in Indiana (28156319A) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1154081602
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMERLENE T RICHARDSONCredential: FNP-BC
Location Address3195 GRANT STGary, IN 46408-1003
Mailing Address3195 Grant StGary, IN 46408-1003 · (219) 887-0900
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 26, 2021
Last NPPES UpdateMarch 28, 2022
NPPES CertifiedMarch 28, 2022
NPI 1154081602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in IN · 28156319A
3195 GRANT ST, Gary, IN 46408

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

Merlene T Richardson Fnp-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 ID1254728207
PECOS Enrollment IDI20220422000272
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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
376 services81 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.
113 services67 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
52 services40 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
48 services24 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
30 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150002
Location600 Grant StGary, IN 46402 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46408 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.06
Improvement Activities40
Cost62.42

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 Merlene Richardson's NPI number?

The NPI number for Merlene Richardson is 1154081602. It was assigned to this individual provider in the NPPES registry on December 26, 2021.

Where is Merlene Richardson located?

Merlene Richardson practices at 3195 Grant St, Gary, IN 46408. The listed phone number is (219) 887-0900.

What is Merlene Richardson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Merlene Richardson enrolled in Medicare?

Yes. Merlene Richardson 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 Merlene Richardson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Merlene Richardson 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.

Is Merlene Richardson affiliated with any hospitals?

According to CMS data, Merlene Richardson is affiliated with Methodist Hospitals Inc.

When was this NPI record last updated?

The NPPES record for Merlene Richardson was last updated on March 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.