MICHELLE B NEPPLE PAC
NPI 1902893779
Physician Assistant in Waterloo, IA
NPI Status: Active since October 05, 2005
Contact Information
1717 W RIDGEWAY AVE
WATERLOO, IA
ZIP 50701
Phone: (319) 233-0340
Fax: (319) 233-0666
- Individual
- Female
- Years of Experience 23
- Physician Assistant
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About MICHELLE NEPPLE
This page provides the complete NPI Profile along with additional information for Michelle Nepple, a primary care provider established in Waterloo, Iowa with a medical specialization in Physician Assistant and more than 23 years of experience. The healthcare provider is registered in the NPI registry with number 1902893779 assigned on October 2005. The practitioner's primary taxonomy code is 363A00000X with license number 1505 (IA). The provider is registered as an individual and her NPI record was last updated 8 years ago.
- NPI
- 1902893779
- Provider Name
- MICHELLE B NEPPLE PAC
- Other Name
- MICHELLE B MOORE PAC
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1717 W RIDGEWAY AVE WATERLOO, IA 50701
- Location Phone
- (319) 233-0340
- Location Fax
- (319) 233-0666
- Mailing Address
- 1717 W RIDGEWAY AVE WATERLOO, IA 50701
- Mailing Phone
- (319) 233-0340
- Mailing Fax
- (319) 233-0666
- Medical School Name
- OTHER
- Graduation Year
- 2003
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-05-2005
- Last Update Date
- 10-12-2018
- Code Navigator
A primary care provider (PCP) like Michelle Nepple sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Secondary Locations
- 2413 W Ridgeway Ave
Waterloo, IA 50701
(319) 233-0340
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 1505
- License State
- IA
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Inspire by Medica Bronze $0 Copay PCP Visits - EPO
- Inspire by Medica Bronze Share - EPO
- Inspire by Medica Expanded Bronze Standard - EPO
- Inspire by Medica Gold $0 Copay PCP Visits - EPO
- Inspire by Medica Gold Share - EPO
- Inspire by Medica Gold Standard - EPO
- Inspire by Medica Silver $0 Copay PCP Visits - EPO
- Inspire by Medica Silver Share - EPO
- Inspire by Medica Silver Standard - EPO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
- Medica Insure Bronze Share - EPO
- Medica Insure Expanded Bronze Standard - EPO
- Medica Insure Gold $0 Copay PCP Visits - EPO
- Medica Insure Gold Share - EPO
- Medica Insure Gold Standard - EPO
- Medica Insure Silver $0 Copay PCP Visits - EPO
- Medica Insure Silver Share - EPO
- Medica Insure Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33583 | OTHER (01) | IA | WELLMARK BCBS |
Medicare Participation & PECOS Enrollment Status
Michelle Nepple is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Michelle Nepple is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 840103115
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20031112000128
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)
3 DME suppliers used 32 Medicare Claims 6390 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Automated urinalysis test
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Ultrasound measurement of bladder capacity after voiding
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
This service was performed 179 times for 123 patientsThis 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.
This service was performed 142 times for 117 patientsThis 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.
This service was performed 88 times for 76 patientsUltrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
This service was performed 173 times for 124 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 50701 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.84
- Minimum New Patient Price $52.96
- Maximum New Patient Price $161.4
- Average New Patient Copayment $20.46
- Minimum New Patient Copayment $13.24
- Maximum New Patient Copayment $40.35
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.36
- Minimum Established Patient Price $16.91
- Maximum Established Patient Price $131.98
- Average Established Patient Copayment $16.59
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $32.99
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michelle Nepple is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ALLEN HOSPITAL | 1825 LOGAN AVENUE WATERLOO, IA 50703 | (319) 235-3941 | Acute Care Hospitals | |
| FINLEY HOSPITAL | 350 NORTH GRANDVIEW AVENUE DUBUQUE, IA 52001 | (563) 582-1881 | Acute Care Hospitals | |
| GRUNDY COUNTY MEMORIAL HOSPITAL | 201 EAST J AVENUE GRUNDY CENTER, IA 50638 | (319) 824-5421 | Critical Access Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1902893779, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
WATERLOO, IA 50701
WATERLOO, IA 50701
WATERLOO, IA 50701
WATERLOO, IA 50701
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902893779, enumerated as an "individual" on October 05, 2005.
The provider is located at 1717 W RIDGEWAY AVE WATERLOO, IA 50701 and the phone number is (319) 233-0340.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Medica, Blue Cross Blue Shield, Wellmark, Medicare. Please consult your insurance carrier or call the provider to verify.
Michelle Nepple is affiliated with: ALLEN HOSPITAL, FINLEY HOSPITAL and GRUNDY COUNTY MEMORIAL HOSPITAL.