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MELANIE L. BANAL NP-C
NPI 1770986010
Nurse Practitioner in Breese, IL

Active since October 01, 2014PECOS Enrolled
94.61/100
CMS Quality Rating
14160 JAMESTOWN RD, BREESE, IL 62230(618) 526-7154(618) 526-8248 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2021, May 19, 2020, Aug 16, 2018 (3 updates tracked since 2018).

About Melanie L. Banal Np-c NPPES

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

MELANIE L. BANAL NP-C (NPI 1770986010) is an individual nurse practitioner in Breese, Illinois, licensed in Illinois (209011871) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS, is affiliated with Gateway Regional Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1770986010
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMELANIE L. BANALCredential: NP-C
Location Address14160 JAMESTOWN RDBreese, IL 62230-3694
Mailing Address14160 Jamestown RdBreese, IL 62230-3694 · (618) 526-7154 · Fax (618) 526-8248
Phone(618) 526-7154
Fax(618) 526-8248
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 1, 2014
Last NPPES UpdateMarch 22, 20223 updates tracked since enumeration
NPPES CertifiedMarch 22, 2022
✔ NPI 1770986010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209011871
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.
14160 JAMESTOWN RD, Breese, IL 62230
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melanie L. Banal Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567684012
PECOS Enrollment IDI20160506001023
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

4

Medicare enrollment records show Melanie Banal reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Anderson Medical Group, LLC
24 mi
General Practice
6810 STATE ROUTE 162, SUITE 215
Maryville, IL 62062
  • Reassigned Medicare billing, Illinois enrollment
  • 145 clinicians in this Medicare group
NPI 1700807716 (618) 288-5711
Ahs Il Medical Group LLC
34 mi
Clinic/Center
2100 MADISON AVE
Granite City, IL 62040
  • Reassigned Medicare billing, Illinois enrollment
  • 107 clinicians in this Medicare group
NPI 1659098101 (818) 666-0602
Mcdonough County Hospital District
140 mi
Internal Medicine
525 E GRANT ST
Macomb, IL 61455
  • Reassigned Medicare billing, Illinois enrollment
  • Also billed through NPI 1992041511 (Illinois)
  • 77 clinicians in this Medicare group
NPI 1609180082 (309) 833-4101
Physicians Immediate Care North Chicago LLC
248 mi
Urgent Care
4211 N CICERO AVE, SUITE 100
Chicago, IL 60641
  • Reassigned Medicare billing, Illinois enrollment
  • 366 clinicians in this Medicare group
NPI 1205814118 (815) 713-2738

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
19 services16 patients

Hospital Affiliations CMS Care Compare

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

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140125
Location2100 Madison AvenueGranite City, IL 62040 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62230 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier12 claims12 services$14.72 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 5

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

DR. MEAGHAN BRITTANY WEEDON DPT
Physical Therapist
14160 JAMESTOWN RD
BREESE, IL 62230
Clinton County (618) 526-5436
COMPETITIVE EDGE SPORTS MEDICINE
Family Medicine (Sports Medicine)
14160 JAMESTOWN RD
BREESE, IL 62230
Clinton County (618) 526-2603
HSHS PRAIRIE, INC
Durable Medical Equipment & Medical Supplies
14160 JAMESTOWN RD
BREESE, IL 62230
Clinton County (618) 526-7154
LESLIE KOHNEN PT, DPT
Physical Therapist
14160 JAMESTOWN RD
BREESE, IL 62230
Clinton County (618) 526-5628
DAVID LOUIS KEE DPM
Podiatrist (Foot & Ankle Surgery)
14160 JAMESTOWN RD
BREESE, IL 62230
Clinton County (618) 526-7154

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 Melanie Banal's NPI number?

The NPI number for Melanie Banal is 1770986010. It was assigned to this individual provider in the NPPES registry on October 1, 2014.

Where is Melanie Banal located?

Melanie Banal practices at 14160 Jamestown Rd, Breese, IL 62230. The listed phone number is (618) 526-7154.

What is Melanie Banal's specialty?

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

Is Melanie Banal enrolled in Medicare?

Yes. Melanie Banal is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Melanie Banal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melanie Banal reassigns Medicare benefits to 4 organizations: Anderson Medical Group, LLC (Maryville, IL), Ahs Il Medical Group LLC (Granite City, IL), Mcdonough County Hospital District (Macomb, IL) and Physicians Immediate Care North Chicago LLC (Chicago, IL). 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 Melanie Banal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Melanie Banal accept?

Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Melanie Banal 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 Melanie Banal affiliated with any hospitals?

According to CMS data, Melanie Banal is affiliated with Gateway Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Melanie Banal was last updated on March 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.