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

Q: 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.

Q: What is Melanie Banal's specialty?

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

Q: 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.

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: August 02, 2026.

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

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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 Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

Quality

85.17

Promoting Interoperability

100

Improvement Activities

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.

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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