MELANIE LYN HERBERT NP
NPI 1295301273
Nurse Practitioner - Adult Health in Buffalo, NY

Active since June 01, 2021PECOS EnrolledAccepts Medicare Assignment
85.47/100
CMS Quality Rating
40 GEORGE KARL BLVD, BUFFALO, NY 14221(716) 250-2000 Get Directions Write a Review

NPPES record last updated: June 1, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 12, 2022, Jun 24, 2021, Jun 1, 2021 (3 updates tracked since 2021).

About Melanie Lyn Herbert Np NPPES

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

MELANIE LYN HERBERT NP (NPI 1295301273) is an individual adult health provider in Buffalo, New York, licensed in New York (F310195-01) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Sisters Of Charity Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1295301273
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMELANIE LYN HERBERTCredential: NP
Location Address40 GEORGE KARL BLVDBuffalo, NY 14221-7183
Mailing Address3980 Sheridan DrAmherst, NY 14226-1727 · (716) 250-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJune 1, 2021
Last NPPES UpdateJune 1, 20223 updates tracked since enumeration
NPPES CertifiedJune 1, 2022
NPI 1295301273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in NY · F310195-01
40 GEORGE KARL BLVD, Buffalo, NY 14221

Secondary Practice Locations 2

Location 1100 High StBuffalo, NY 14203-1126 · Phone (716) 859-5600
Location 2100 High Street, Section B2Buffalo, NY 14203-1126 · Phone (716) 710-8266 · Fax (716) 859-3971

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

Melanie Lyn Herbert Np 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 ID5890196760
PECOS Enrollment IDI20210629002984
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 2

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.

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.
382 services263 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
69 services23 patients

Hospital Affiliations CMS Care Compare 5

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

Sisters Of Charity Hospital

Acute Care Hospitals · Buffalo, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330078
Location2157 Main StreetBuffalo, NY 14214 · Erie County
Emergency services Birthing friendly

Bertrand Chaffee Hospital

Acute Care Hospitals · Springville, NY
OwnershipVoluntary non-profit - Church
CMS Certification Number330111
Location224 East Main StreetSpringville, NY 14141 · Erie County
Emergency services

Brooks-Tlc Hospital System, Inc

Acute Care Hospitals · Dunkirk, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330229
Location529 Central AvenueDunkirk, NY 14048 · Chautauqua County
Emergency services

Upmc Chautauqua At Wca

Acute Care Hospitals · Jamestown, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330239
Location207 Foote AvenueJamestown, NY 14701 · Chautauqua County
Emergency services Birthing friendly

Mercy Hospital Of Buffalo

Acute Care Hospitals · Buffalo, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330279
Location565 Abbott RoadBuffalo, NY 14220 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14221 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

85.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.9
Promoting Interoperability52
Improvement Activities40
Cost99.99

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.

Neurological Surgery
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Pain Medicine (Interventional Pain Medicine)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Psychiatry & Neurology (Neurology)
40 GEORGE KARL BLVD
BUFFALO, NY 14221
Physical Therapist
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Physician Assistant (Surgical)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Neurological Surgery
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Nurse Practitioner (Family)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Psychiatry & Neurology (Neurology)
40 GEORGE KARL BLVD
BUFFALO, NY 14221

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 Melanie Herbert's NPI number?

The NPI number for Melanie Herbert is 1295301273. It was assigned to this individual provider in the NPPES registry on June 1, 2021.

Where is Melanie Herbert located?

Melanie Herbert practices at 40 George Karl Blvd, Buffalo, NY 14221. The listed phone number is (716) 250-2000.

What is Melanie Herbert's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Melanie Herbert enrolled in Medicare?

Yes. Melanie Herbert 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.

Is Melanie Herbert affiliated with any hospitals?

According to CMS data, Melanie Herbert is affiliated with Sisters Of Charity Hospital, Bertrand Chaffee Hospital, Brooks-Tlc Hospital System, Inc, Upmc Chautauqua At Wca and Mercy Hospital Of Buffalo.

When was this NPI record last updated?

The NPPES record for Melanie Herbert was last updated on June 1, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.