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MEGAN K EDMISTEN NP-C
NPI 1902270069
Nurse Practitioner - Family in Knoxville, TN

Active since November 30, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
9901 SIERRA VISTA LN, KNOXVILLE, TN 37922(865) 599-0300 Get Directions Write a Review

NPPES record last updated: November 30, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Megan K Edmisten Np-c NPPES

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

MEGAN K EDMISTEN NP-C (NPI 1902270069) is an individual family provider in Knoxville, Tennessee, licensed in Tennessee (20677) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS, is affiliated with Blount Memorial Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1902270069
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMEGAN K EDMISTENCredential: NP-C
Location Address9901 SIERRA VISTA LNKnoxville, TN 37922-5736
Mailing Address9901 Sierra Vista LnKnoxville, TN 37922-5736 · (865) 599-0300
Phone(865) 599-0300
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateNovember 30, 2015
✔ NPI 1902270069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 20677
9901 SIERRA VISTA LN, Knoxville, TN 37922
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health 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

Megan K Edmisten Np-c 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 ID4183926942
PECOS Enrollment IDI20160111001841
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.

Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled P9603
This service covers travel costs for healthcare professionals to collect necessary lab specimens from patients who are homebound or in nursing homes. The allowance is calculated based on the actual miles traveled to perform this service.
5,032 services64 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
939 services126 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
184 services91 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.
138 services66 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
58 services38 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
58 services47 patients

Hospital Affiliations CMS Care Compare 2

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

Blount Memorial Hospital

Acute Care Hospitals · Maryville, TN
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number440011
Location907 E Lamar Alexander ParkwayMaryville, TN 37804 · Blount County
Emergency services Birthing friendly

Methodist Medical Center Of Oak Ridge

Acute Care Hospitals · Oak Ridge, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440034
Location990 Oak Ridge Turnpike Box 529Oak Ridge, TN 37830 · Anderson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37922 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
2%43 patients1/55-star benchmark: 96%
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…
80%351 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
96%2,151 patients4/55-star benchmark: 100%
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%129 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 5

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers49 claims49 services$43.01 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers38 claims38 services$15.51 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier21 claims21 services$6.79 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
3 suppliers49 claims49 services$72.99 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
2 suppliers20 claims20 services$33.51 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

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

DR. SUSAN REYES MD
Internal Medicine
9901 SIERRA VISTA LN
KNOXVILLE, TN 37922
Knox County (865) 599-0300

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 Megan Edmisten's NPI number?

The NPI number for Megan Edmisten is 1902270069. It was assigned to this individual provider in the NPPES registry on November 30, 2015.

Where is Megan Edmisten located?

Megan Edmisten practices at 9901 Sierra Vista Ln, Knoxville, TN 37922. The listed phone number is (865) 599-0300.

What is Megan Edmisten's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Megan Edmisten enrolled in Medicare?

Yes. Megan Edmisten 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 Megan Edmisten accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Megan Edmisten 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 Megan Edmisten affiliated with any hospitals?

According to CMS data, Megan Edmisten is affiliated with Blount Memorial Hospital and Methodist Medical Center Of Oak Ridge.

When was this NPI record last updated?

The NPPES record for Megan Edmisten was last updated on November 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.