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MELISSA ANN DOUGHTY AGACNP
NPI 1346912433
Nurse Practitioner in Erie, PA

Active since September 28, 2021PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
204 W 26TH ST, ERIE, PA 16508(814) 864-4755(814) 864-5430 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Melissa Ann Doughty Agacnp NPPES

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

MELISSA ANN DOUGHTY AGACNP (NPI 1346912433) is an individual nurse practitioner in Erie, Pennsylvania, licensed in Pennsylvania (SP027132) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Saint Vincent Hospital, and maintains a secondary practice location in Beachwood.

NPPES Registry Identity

NPI1346912433
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMELISSA ANN DOUGHTYCredential: AGACNP
Location Address204 W 26TH STErie, PA 16508-1806
Mailing Address13633 Ridge RdWest Springfield, PA 16443-9447 · (814) 882-5318
Phone(814) 864-4755
Fax(814) 864-5430
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 28, 2021
Last NPPES UpdateApril 26, 2023
NPPES CertifiedApril 26, 2023
✔ NPI 1346912433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in PA · SP027132
Definition
(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.
Also ListedNurse Practitioner · Critical Care MedicineTaxonomy 363LC0200X · License 0027913 (OH)
204 W 26TH ST, Erie, PA 16508
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Secondary Practice Location 1

Location 13999 Richmond RdBeachwood, OH 44122-6046 · Phone (216) 593-1540

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Ohio, Inc., CareSource, MedMutual.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

Melissa Ann Doughty Agacnp 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 ID8224429790
PECOS Enrollment IDI20230523002109
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.

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.
68 services67 patients
Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes 99236
This service involves a brief hospital stay for a serious health issue. Patients are admitted and discharged on the same day, typically within 55 minutes. It allows for close monitoring and immediate treatment, ensuring optimal care.
21 services20 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Vincent Hospital

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390009
Location232 West 25th StreetErie, PA 16544 · Erie County
Emergency services Birthing friendly

Warren General Hospital

Acute Care Hospitals · Warren, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390146
LocationTwo Crescent Park WestWarren, PA 16365 · Warren County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16508 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

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.

MR. THOMAS M JOHNSON PA-C
Physician Assistant
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 864-4755
DR. AMANDA MARIE LINDO MD
Internal Medicine (Pulmonary Disease)
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 864-4755
SEAN DENT
Nurse Practitioner (Acute Care)
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 864-4755
MR. HRIDYESH SIKRI M.D.
Internal Medicine (Critical Care Medicine)
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 864-4755
ST VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE INC.
Orthopaedic Surgery
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 454-2401
JOHN KARSTENS
Internal Medicine (Sleep Medicine)
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 868-7581
DR. ANIMESH CHIDANANDRAO GOUR MD
Internal Medicine (Pulmonary Disease)
204 W 26TH ST
ERIE, PA 16508
Erie County (347) 981-5667
KIET MA D.O.
Internal Medicine (Pulmonary Disease)
204 W 26TH ST
ERIE, PA 16508
Erie County (814) 864-4755

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 Doughty's NPI number?

The NPI number for Melissa Doughty is 1346912433. It was assigned to this individual provider in the NPPES registry on September 28, 2021.

Where is Melissa Doughty located?

Melissa Doughty practices at 204 W 26th St, Erie, PA 16508. The listed phone number is (814) 864-4755.

What is Melissa Doughty's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Melissa Doughty enrolled in Medicare?

Yes. Melissa Doughty 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 Melissa Doughty accept?

Health plans from Antidote Health Plan of Ohio, Inc., CareSource and MedMutual list Melissa Doughty 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 Melissa Doughty affiliated with any hospitals?

According to CMS data, Melissa Doughty is affiliated with Saint Vincent Hospital and Warren General Hospital.

When was this NPI record last updated?

The NPPES record for Melissa Doughty was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.