1. Home
  2. Directory
  3. Pennsylvania
  4. Punxsutawney
  5. Nurse Practitioner
  6. NPI Profile

DONALD M. PALLONE CRNP
NPI 1932384138
Nurse Practitioner - Family in Punxsutawney, PA

Active since January 07, 2008PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
531 NORTH MAIN STREET, PUNXSUTAWNEY, PA 15767(814) 249-7583(814) 249-7584 Get Directions Write a Review

NPPES record last updated: August 24, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 24, 2023, Jul 28, 2023 (2 updates tracked since 2023).

About Donald M. Pallone Crnp NPPES

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

DONALD M. PALLONE CRNP (NPI 1932384138) is an individual family provider in Punxsutawney, Pennsylvania, licensed in Pennsylvania (SP009632) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Dubois, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1932384138
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDONALD M. PALLONECredential: CRNP
Location Address531 NORTH MAIN STREETPunxsutawney, PA 15767
Mailing Address531 North Main StreetPunxsutawney, PA 15767 · (814) 249-7583 · Fax (814) 249-7584
Phone(814) 249-7583
Fax(814) 249-7584
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJanuary 7, 2008
Last NPPES UpdateAugust 24, 20232 updates tracked since enumeration
NPPES CertifiedAugust 24, 2023
✔ NPI 1932384138 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 PA · SP009632
531 NORTH MAIN STREET, Punxsutawney, PA 15767
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Donald M. Pallone Crnp 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 ID5698850790
PECOS Enrollment IDI20080313000495
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 5

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 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.
108 services47 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.
79 services44 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.
20 services20 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
12 services11 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Penn Highlands Dubois

Acute Care Hospitals · Dubois, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390086
Location100 Hospital AvenueDubois, PA 15801 · Clearfield County

Punxsutawney Area Hospital

Acute Care Hospitals · Punxsutawney, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390199
Location81 Hillcrest DrivePunxsutawney, PA 15767 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15767 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

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…
2%132 patients1/55-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…
31%162 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 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 suppliers54 claims104 services$5.70 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers17 claims17 services$0.93 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers15 claims15 services$7.29 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 suppliers12 claims12 services$177.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Donald Pallone's NPI number?

The NPI number for Donald Pallone is 1932384138. It was assigned to this individual provider in the NPPES registry on January 7, 2008.

Where is Donald Pallone located?

Donald Pallone practices at 531 North Main Street, Punxsutawney, PA 15767. The listed phone number is (814) 249-7583.

What is Donald Pallone's specialty?

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

Is Donald Pallone enrolled in Medicare?

Yes. Donald Pallone 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 Donald Pallone accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Donald Pallone 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 Donald Pallone affiliated with any hospitals?

According to CMS data, Donald Pallone is affiliated with Penn Highlands Dubois and Punxsutawney Area Hospital.

When was this NPI record last updated?

The NPPES record for Donald Pallone was last updated on August 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.