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MICALYN D BANEY DO
NPI 1467579011
Family Medicine in Waterford, PA

Active since March 26, 2007PECOS EnrolledAccepts Medicare Assignment
220 E 3RD ST, WATERFORD, PA 16441(814) 796-6791(814) 796-6517 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2023, Aug 7, 2017, Jan 4, 2017 (3 updates tracked since 2017).

About Micalyn D Baney Do NPPES

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

MICALYN D BANEY DO (NPI 1467579011) is an individual family medicine provider in Waterford, Pennsylvania, licensed in Pennsylvania (OS014005) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Saint Vincent Hospital, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2004).

NPPES Registry Identity

NPI1467579011
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMICALYN D BANEYCredential: DO
Location Address220 E 3RD STWaterford, PA 16441
Mailing Address1 Lecom PlErie, PA 16505-2571 · Fax (814) 868-2522
Phone(814) 796-6791
Fax(814) 796-6517
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2004
Enumeration DateMarch 26, 2007
Last NPPES UpdateMarch 1, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 28, 2023
✔ NPI 1467579011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS014005
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
220 E 3RD ST, Waterford, PA 16441
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Other Identifiers 1

Medicaid1019257770001PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Micalyn D Baney Do 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 ID1153422845
PECOS Enrollment IDI20070725000283
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 7

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 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.
272 services102 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
235 services119 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
91 services91 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
89 services89 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
36 services35 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
32 services31 patients

Hospital Affiliations CMS Care Compare 5

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

Upmc Hamot

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390063
Location201 State StreetErie, PA 16550 · Erie County
Emergency services Birthing friendly

Meadville Medical Center

Acute Care Hospitals · Meadville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390113
Location751 Liberty StreetMeadville, PA 16335 · Crawford County
Emergency services Birthing friendly

Millcreek Community Hospital

Acute Care Hospitals · Erie, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390198
Location5515 Peach StreetErie, PA 16509 · Erie County
Emergency services

Lecom Health Corry Memorial Hospital

Critical Access Hospitals · Corry, PA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number391308
Location965 Shamrock LaneCorry, PA 16407 · Erie County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16441 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.

Reported Quality Measures

Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%113 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers30 claims59 services$4.91 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers16 claims19 services$0.71 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
3 suppliers15 claims15 services$38.78 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 supplier11 claims11 services$81.45 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers19 claims19 services$199.03 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 2

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

MIRANDA MARIE DEERING PA-C
Physician Assistant
220 E 3RD ST
WATERFORD, PA 16441
Erie County (814) 796-6791
MILLCREEK COMMUNITY HOSPITAL
Family Medicine
220 E 3RD ST
WATERFORD, PA 16441
Erie County (814) 796-6791

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 Micalyn Baney's NPI number?

The NPI number for Micalyn Baney is 1467579011. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Where is Micalyn Baney located?

Micalyn Baney practices at 220 E 3rd St, Waterford, PA 16441. The listed phone number is (814) 796-6791.

What is Micalyn Baney's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Micalyn Baney enrolled in Medicare?

Yes. Micalyn Baney 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 Micalyn Baney accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Micalyn Baney 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 Micalyn Baney affiliated with any hospitals?

According to CMS data, Micalyn Baney is affiliated with Saint Vincent Hospital, Upmc Hamot, Meadville Medical Center, Millcreek Community Hospital and Lecom Health Corry Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Micalyn Baney was last updated on March 1, 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.