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MELISSA M. M. AGOUDEMOS M.D.
NPI 1518175579
Pediatrics - Pediatric Cardiology in Meridian, ID

Active since May 21, 2007PECOS Enrolled
83.32/100
CMS Quality Rating
520 S EAGLE RD, SUITE 2204, MERIDIAN, ID 83642(208) 336-9188(208) 336-2636 Get Directions Write a Review

NPPES record last updated: April 18, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Melissa M. M. Agoudemos M.d. NPPES

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

MELISSA M. M. AGOUDEMOS M.D. (NPI 1518175579) is an individual pediatric cardiology provider in Meridian, Idaho, licensed in Illinois (036-125447) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518175579
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameMELISSA M. M. AGOUDEMOSCredential: M.D.
Location Address520 S EAGLE RD, SUITE 2204Meridian, ID 83642-6351
Mailing Address520 S Eagle Rd, Suite 2204Meridian, ID 83642-6351 · (208) 336-9188 · Fax (208) 336-2636
Phone(208) 336-9188
Fax(208) 336-2636
Sole ProprietorNo
Enumeration DateMay 21, 2007
Last NPPES UpdateApril 18, 2017
✔ NPI 1518175579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in IL · 036-125447
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License R-8001 (IA)
520 S EAGLE RD, Meridian, ID 83642
Open in Google Maps ↗

Other Identifiers 2

Medicaid036125447IL
Medicare PIN256510073IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan 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 (PECOS)

Melissa M. M. Agoudemos M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Agoudemos reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Saint Alphonsus Regional Medical Center Inc
4.9 mi
Psychologist
1055 N CURTIS RD
Boise, ID 83706
  • Reassigned Medicare billing, Idaho enrollment
  • 781 clinicians in this Medicare group
NPI 1649357716 (208) 367-4148
St Lukes Clinic-Treasure Valley LLC
8.1 mi
Family Medicine
190 E BANNOCK ST
Boise, ID 83712
  • Reassigned Medicare billing, Idaho enrollment
  • 1,312 clinicians in this Medicare group
NPI 1326336058 (208) 381-2222

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

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.

83.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.51
Promoting Interoperability100
Improvement Activities40
Cost64.88

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.

DR. MAGGIE D. VUTURO MD
Urology (Urogynecology and Reconstructive Pelvic Surgery)
520 S EAGLE RD, STE 3112
MERIDIAN, ID 83642
Ada County (208) 706-5800
MICHAEL J GRIFFITHS RPH
Pharmacist
520 S EAGLE RD
MERIDIAN, ID 83642
Ada County (208) 706-5255
ROBIN MCGAW HUGHES PT
Physical Therapist
520 S EAGLE RD
MERIDIAN, ID 83642
Ada County (208) 381-4757
MRS. AUDREY GYUNG NGUYEN PHARMD
Pharmacist (Pharmacotherapy)
520 S EAGLE RD
MERIDIAN, ID 83642
Ada County (208) 706-1523
MR. BENJAMIN WATSON PA-C
Physician Assistant (Medical)
520 S EAGLE RD, SUITE 1234
MERIDIAN, ID 83642
Ada County (661) 332-9138
NICOLE DANIELLE BORCYK OTR/L
Occupational Therapist
520 S EAGLE RD
MERIDIAN, ID 83642
Ada County (208) 706-5000
CRAIG R SPENCER MD
Urology
520 S EAGLE RD, STE 3112
MERIDIAN, ID 83642
Ada County (208) 706-5800
TRAVIS G WILLIAMS DO
Internal Medicine (Medical Oncology)
520 S EAGLE RD
MERIDIAN, ID 83642
Ada County (208) 706-5651

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 Agoudemos's NPI number?

The NPI number for Melissa Agoudemos is 1518175579. It was assigned to this individual provider in the NPPES registry on May 21, 2007.

Where is Melissa Agoudemos located?

Melissa Agoudemos practices at 520 S Eagle Rd Suite 2204, Meridian, ID 83642. The listed phone number is (208) 336-9188.

What is Melissa Agoudemos's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Melissa Agoudemos enrolled in Medicare?

Yes. Melissa Agoudemos is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Melissa Agoudemos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melissa Agoudemos reassigns Medicare benefits to 2 organizations: Saint Alphonsus Regional Medical Center Inc (Boise, ID) and St Lukes Clinic-Treasure Valley LLC (Boise, ID). 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 Agoudemos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Melissa Agoudemos accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Melissa Agoudemos 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 Agoudemos was last updated on April 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.