DR. ACHENEF GETU MELESE M.D
NPI 1609164136
Hospitalist in Gainesville, GA

Q: What is Achenef Melese's NPI number?

The NPI number for Achenef Melese is 1609164136. It was assigned to this individual provider in the NPPES registry on July 18, 2011.

Q: What is Achenef Melese's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Achenef Melese was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since July 18, 2011PECOS EnrolledAccepts Medicare Assignment

98.31/100

CMS Quality Rating

743 SPRING ST NE, GAINESVILLE, GA 30501(770) 219-6000 Get Directions Write a Review

NPPES record last updated: June 21, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 21, 2018, Apr 27, 2017 (2 updates tracked since 2017).

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About Dr. Achenef Getu Melese M.d NPPES

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

DR. ACHENEF GETU MELESE M.D (NPI 1609164136) is an individual hospitalist provider in Gainesville, Georgia, licensed in Georgia (080617) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1609164136

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. ACHENEF GETU MELESECredential: M.D

Location Address743 SPRING ST NEGainesville, GA 30501

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(770) 219-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJuly 18, 2011

Last NPPES UpdateJune 21, 20182 updates tracked since enumeration

✔ NPI 1609164136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

Licenses✔ Licensed in GA · 080617✔ Licensed in OH · 35. 126068

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

743 SPRING ST NE, Gainesville, GA 30501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Dr. Achenef Getu Melese M.d 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 ID2062723984

PECOS Enrollment IDI20180820002508

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

652 services235 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

157 services86 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

97 services97 patients

Hospital Affiliations CMS Care Compare

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

98.31/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

97.88

Improvement Activities

Cost

84.56

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

52%100 patients2/55-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 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

4 suppliers30 claims30 services$14.75 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

4 suppliers37 claims37 services$64.15 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 20

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

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