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DR. MELISSA D KOEHLER DO
NPI 1477754869
Obstetrics & Gynecology in Appleton, WI

Active since May 31, 2007PECOS EnrolledAccepts Medicare Assignment
1531 S MADISON ST, APPLETON, WI 54915(920) 730-4413 Get Directions Write a Review

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 11, 2020, Jul 3, 2019 (2 updates tracked since 2019).

About Dr. Melissa D Koehler Do NPPES

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

DR. MELISSA D KOEHLER DO (NPI 1477754869) is an individual obstetrics & gynecology provider in Appleton, Wisconsin, licensed in Wisconsin (51548) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (2004).

NPPES Registry Identity

NPI1477754869
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. MELISSA D KOEHLERCredential: DO
Location Address1531 S MADISON STAppleton, WI 54915-1800
Mailing Address1531 S Madison StAppleton, WI 54915-1800 · (920) 730-4413
Phone(920) 730-4413
Sole ProprietorNo
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 2004
Enumeration DateMay 31, 2007
Last NPPES UpdateDecember 11, 20202 updates tracked since enumeration
NPPES CertifiedDecember 11, 2020
✔ NPI 1477754869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in WI · 51548✔ Licensed in NC · 122103
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1531 S MADISON ST, Appleton, WI 54915
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Other Identifiers 1

Medicaid37582400WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Melissa D Koehler 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 ID749357697
PECOS Enrollment IDI20080918000705
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Melissa Koehler reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Women's Health Specialists, S.C.
2.2 mi
Obstetrics & Gynecology
1818 N MEADE ST
Appleton, WI 54911
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Womens Health Specialists Sc
  • 25 clinicians in this Medicare group
NPI 1417086216 (920) 749-4000
Ascension Medical Group-Fox Valley Wisconsin, Inc
5.2 mi
Multi-Specialty
101 MAIN ST
Neenah, WI 54956
  • Reassigned Medicare billing, Wisconsin enrollment
  • 444 clinicians in this Medicare group
NPI 1730126392 (920) 727-4200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.
13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54915 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
90%124 patients4/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
84%464 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
84%137 patients4/55-star benchmark: 85%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%1,093 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
97%191 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
54%985 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
49%508 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 386 patients
Patients tobacco: 16% · 32 patients
92%386 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%985 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
36%985 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
45%985 patients
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.

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.

KAILIE BECK ANPN, FNP-C
Nurse Practitioner (Family)
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 738-2000
MS. MICHELLE KENNEDY COENEN MS
Social Worker (Clinical)
1531 S MADISON ST, STE 550
APPLETON, WI 54915
Calumet County (920) 738-2700
ANNEMARIE UPHUS APNP, PMHNP-BC, CNM
Nurse Practitioner
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4411
DEBRA L. FRANCIOSI APNP
Nurse Practitioner (Psychiatric/Mental Health)
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4411
JENNIFER L CASTRO SAC
Counselor (Addiction (Substance Use Disorder))
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 831-8437
THOMAS G HOEFT D.O.
Orthopaedic Surgery
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 996-3700
CHRISTOPHER W WAGENER MD
Obstetrics & Gynecology
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4413
DR. LEE W HASH M.D.
Orthopaedic Surgery
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 996-3700

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 Koehler's NPI number?

The NPI number for Melissa Koehler is 1477754869. It was assigned to this individual provider in the NPPES registry on May 31, 2007.

Where is Melissa Koehler located?

Melissa Koehler practices at 1531 S Madison St, Appleton, WI 54915. The listed phone number is (920) 730-4413.

What is Melissa Koehler's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Melissa Koehler enrolled in Medicare?

Yes. Melissa Koehler 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.

Which organizations bill Medicare for Melissa Koehler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melissa Koehler reassigns Medicare benefits to 2 organizations: Women's Health Specialists, S.C. (Appleton, WI) and Ascension Medical Group-Fox Valley Wisconsin, Inc (Neenah, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Melissa Koehler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Melissa Koehler accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan and HealthPartners and 2 other insurers list Melissa Koehler 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.

When was this NPI record last updated?

The NPPES record for Melissa Koehler was last updated on December 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.