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MELANIE MOONEY M.D.
NPI 1861462970
Family Medicine in Rincon, GA

Active since January 23, 2006PECOS EnrolledAccepts Medicare Assignment
75.03/100
CMS Quality Rating
423 S COLUMBIA AVE, RINCON, GA 31326(912) 826-8860(912) 826-2813 Get Directions Write a Review

NPPES record last updated: June 4, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Melanie Mooney M.d. NPPES

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

MELANIE MOONEY M.D. (NPI 1861462970) is an individual family medicine provider in Rincon, Georgia, licensed in South Carolina (39861) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, is affiliated with Candler Hospital, and is a graduate of University Of Louisville School Of Medicine (2001).

NPPES Registry Identity

NPI1861462970
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMELANIE MOONEYCredential: M.D.
Location Address423 S COLUMBIA AVERincon, GA 31326
Mailing Address602 E 72nd StSavannah, GA 31405-4913 · (912) 819-7878 · Fax (912) 819-7850
Phone(912) 826-8860
Fax(912) 826-2813
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2001
Enumeration DateJanuary 23, 2006
Last NPPES UpdateJune 4, 2018
✔ NPI 1861462970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 39861
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
423 S COLUMBIA AVE, Rincon, GA 31326
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Other Identifiers 2

Medicaid64065360SC
Medicaid64065360KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Melanie Mooney 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 ID1759369747
PECOS Enrollment IDI20180702000426
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 11

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.
432 services191 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
242 services154 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
95 services62 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
79 services79 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
52 services44 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
51 services39 patients

Hospital Affiliations CMS Care Compare 4

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

Candler Hospital

Acute Care Hospitals · Savannah, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110024
Location5353 Reynolds StreetSavannah, GA 31412 · Chatham County
Emergency services Birthing friendly

Memorial University Medical Center

Acute Care Hospitals · Savannah, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110036
Location4700 Waters AvenueSavannah, GA 31404 · Chatham County
Emergency services Birthing friendly

St Joseph's Hospital - Savannah

Acute Care Hospitals · Savannah, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110043
Location11705 Mercy BoulevardSavannah, GA 31419 · Chatham County
Emergency services

Effingham Health System

Critical Access Hospitals · Springfield, GA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number111306
Location459 Ga Highway 119 SouthSpringfield, GA 31329 · Effingham County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31326 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
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.

75.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.33
Promoting Interoperability95
Improvement Activities40
Cost51.61

Reported Quality Measures

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.
89%2,374 patients3/55-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…
53%381 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%46 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.
29%702 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…
80%702 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…
39%702 patients2/55-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.
54%702 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 4

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
5 suppliers21 claims76 services$5.84 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
2 suppliers12 claims17 services$1.13 avg. paid by Medicare
Enteral nutrition infusion pump, any type B9002
Other-Enteral and Parenteral · category OB005N
1 supplier11 claims11 services$61.19 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers25 claims25 services$182.50 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 3

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

CARTERS PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
423 S COLUMBIA AVE
RINCON, GA 31326
Effingham County (912) 826-1616
RENEWALMD RINCON
Plastic Surgery
423 S COLUMBIA AVE
RINCON, GA 31326
Effingham County (912) 920-2090
MRS. CHRISTIE LYNN PHILLIPS-FEARIS APRN
Nurse Practitioner (Family)
423 S COLUMBIA AVE
RINCON, GA 31326
Effingham County (912) 826-8860

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 Mooney's NPI number?

The NPI number for Melanie Mooney is 1861462970. It was assigned to this individual provider in the NPPES registry on January 23, 2006.

Where is Melanie Mooney located?

Melanie Mooney practices at 423 S Columbia Ave, Rincon, GA 31326. The listed phone number is (912) 826-8860.

What is Melanie Mooney's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Melanie Mooney enrolled in Medicare?

Yes. Melanie Mooney 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 Melanie Mooney accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Melanie Mooney 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 Mooney affiliated with any hospitals?

According to CMS data, Melanie Mooney is affiliated with Candler Hospital, Memorial University Medical Center, St Joseph's Hospital - Savannah and Effingham Health System.

When was this NPI record last updated?

The NPPES record for Melanie Mooney was last updated on June 4, 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.