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DR. THOMAS P MELANCON M.D.
NPI 1811989197
Internal Medicine in Marrero, LA

Active since August 22, 2005PECOS EnrolledAccepts Medicare Assignment
1111 MEDICAL CENTER BLVD, SUITE 205, MARRERO, LA 70072(504) 392-7999(504) 392-6100 Get Directions Write a Review

NPPES record last updated: August 25, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Thomas P Melancon M.d. NPPES

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

DR. THOMAS P MELANCON M.D. (NPI 1811989197) is an individual internal medicine provider in Marrero, Louisiana, licensed in Louisiana (18656) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Ochsner Medical Center Acute, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1985).

NPPES Registry Identity

NPI1811989197
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THOMAS P MELANCONCredential: M.D.
Location Address1111 MEDICAL CENTER BLVD, SUITE 205Marrero, LA 70072-3151
Mailing Address1111 Medical Center Blvd, Suite 205Marrero, LA 70072-3151 · (504) 392-7999 · Fax (504) 392-6100
Phone(504) 392-7999
Fax(504) 392-6100
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1985
Enumeration DateAugust 22, 2005
Last NPPES UpdateAugust 25, 2010
✔ NPI 1811989197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in LA · 18656
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1111 MEDICAL CENTER BLVD, Marrero, LA 70072
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Other Identifiers 6

Other80752LA · Aetna
Medicare UPIND62754LA
Medicaid1397610LA
Medicare ID-Type Unspecified51460LA
OtherF7245LA · Blue Cross
Other110208321LA · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.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. Thomas P Melancon 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 ID9133262009
PECOS Enrollment IDI20100202000073
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 10

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.

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
372 services27 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
297 services19 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
255 services28 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
192 services24 patients
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.
174 services98 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
153 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Ochsner Medical Center Acute

Acute Care Hospitals · New Orleans, LA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190036
Location1516 Jefferson HwyNew Orleans, LA 70121 · Jefferson County
Emergency services Birthing friendly

West Jefferson Medical Center

Acute Care Hospitals · Marrero, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190039
Location1101 Medical Center BlvdMarrero, LA 70072 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70072 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
$128.88 typical visit price
range $55.50 – $170.30
Typical copayment $32.22 (range $13.87 – $42.57)
Most-billed visit code 99204
Established Patient
$98.35 typical visit price
range $17.42 – $138.03
Typical copayment $24.58 (range $4.35 – $34.50)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
42%804 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
12%273 patients1/55-star benchmark: 100%
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.
99%10,616 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
65%572 patients3/55-star benchmark: 88%
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.
100%360 patients5/55-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.
93%1,296 patients4/55-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…
35%1,294 patients2/55-star benchmark: 97%
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…
87%1,296 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…
65%1,296 patients3/55-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.
34%1,296 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers16 claims40 services$6.59 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers21 claims22 services$2.98 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.

LABADIE AND LABADIE A PROFESSIONAL LLC
Specialist
1111 MEDICAL CENTER BLVD, SUITE 250 SOUTH
MARRERO, LA 70072
Jefferson Parish (504) 349-6207
THELMA SONZA N.P.
Nurse Practitioner (Family)
1111 MEDICAL CENTER BLVD, SUITE 613N
MARRERO, LA 70072
Jefferson Parish (504) 394-6800
DR. JOSEPH GUARNIERI M.D.
Ophthalmology
1111 MEDICAL CENTER BLVD, SUITE N-213
MARRERO, LA 70072
Jefferson Parish (504) 349-6213
CHARLES JOSEPH BALLAY II M.D.
Otolaryngology
1111 MEDICAL CENTER BLVD, SUITE 707N
MARRERO, LA 70072
Jefferson Parish (504) 934-8550
DR. PRAMELA R GANJI MD
Family Medicine
1111 MEDICAL CENTER BLVD, STE 304 NORTH
MARRERO, LA 70072
Jefferson Parish (504) 349-6325
WEST JEFFERSON PHYSICIAN SERVICES
Internal Medicine
1111 MEDICAL CENTER BLVD, SUITE S850
MARRERO, LA 70072
Jefferson Parish (504) 349-6450
MS. MEGHAN CATHERINE MESSONNIER PA-C
Physician Assistant (Medical)
1111 MEDICAL CENTER BLVD, SUITE S-450
MARRERO, LA 70072
Jefferson Parish (504) 349-6423
KAELYNN LANDECHE FRANCISCO APRN
Nurse Practitioner
1111 MEDICAL CENTER BLVD
MARRERO, LA 70072
Jefferson Parish (504) 349-6945

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 Thomas Melancon's NPI number?

The NPI number for Thomas Melancon is 1811989197. It was assigned to this individual provider in the NPPES registry on August 22, 2005.

Where is Thomas Melancon located?

Thomas Melancon practices at 1111 Medical Center Blvd Suite 205, Marrero, LA 70072. The listed phone number is (504) 392-7999.

What is Thomas Melancon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas Melancon enrolled in Medicare?

Yes. Thomas Melancon 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.

What insurance does Thomas Melancon accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Thomas Melancon 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 Thomas Melancon affiliated with any hospitals?

According to CMS data, Thomas Melancon is affiliated with Ochsner Medical Center Acute and West Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Thomas Melancon was last updated on August 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.