MELISSA A. HILBORN PA-C
NPI 1306943766
Physician Assistant in Spencer, MA

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
118 W MAIN ST, SPENCER, MA 01562(508) 885-3025(508) 885-4090 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 25, 2021, Jan 22, 2021, May 11, 2018 and 1 more (4 updates tracked since 2016).

About Melissa A. Hilborn Pa-c NPPES

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

MELISSA A. HILBORN PA-C (NPI 1306943766) is an individual physician assistant in Spencer, Massachusetts, licensed in Massachusetts (PA5642) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Health - Harrington Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1306943766
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMELISSA A. HILBORNCredential: PA-C
Location Address118 W MAIN STSpencer, MA 01562-2621
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Fax(508) 885-4090
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateSeptember 20, 2006
Last NPPES UpdateMarch 25, 20214 updates tracked since enumeration
NPPES CertifiedMarch 25, 2021
NPI 1306943766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MA · PA5642
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

118 W MAIN ST, Spencer, MA 01562

Other Identifiers 1

Other1051985Nccpa Certification

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

Melissa A. Hilborn Pa-c 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 ID648223529
PECOS Enrollment IDI20160504000707
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.

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.
130 services92 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.
90 services74 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
16 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220019
Location100 South StreetSouthbridge, MA 01550 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Worcester, MA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number220176
Location123 Summer StreetWorcester, MA 01608 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01562 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$14.79 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$67.46 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

Physician Assistant (Medical)
118 W MAIN ST
SPENCER, MA 01562
Internal Medicine
118 W MAIN ST
SPENCER, MA 01562
Internal Medicine
118 W MAIN ST
SPENCER, MA 01562
Internal Medicine
118 W MAIN ST
SPENCER, MA 01562
Internal Medicine
118 W MAIN ST
SPENCER, MA 01562

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 Melissa Hilborn's NPI number?

The NPI number for Melissa Hilborn is 1306943766. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Melissa Hilborn located?

Melissa Hilborn practices at 118 W Main St, Spencer, MA 01562. The listed phone number is (508) 885-3025.

What is Melissa Hilborn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Melissa Hilborn enrolled in Medicare?

Yes. Melissa Hilborn 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 Melissa Hilborn affiliated with any hospitals?

According to CMS data, Melissa Hilborn is affiliated with Umass Memorial Health - Harrington Hospital, Umass Memorial Medical Center/University Campus and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Melissa Hilborn was last updated on March 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.