Individual provider Active NPI

Melissa May Deer Pelletier, D.O.

  • Obstetrics & Gynecology Physician
  • Naperville, IL
National Provider Identifier
1104231620
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036157477 Issued in IL
Practice address
636 Raymond Dr Ste 303
Naperville, IL 60563-9792
Phone
(630) 653-4240
Fax
(630) 315-1505
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X TEP7304 NE
Obstetrics & Gynecology Physician 207V00000X DO-05216 IA
Obstetrics & Gynecology Physician 207V00000X 036157477 IL Primary

Addresses

Primary practice location

636 Raymond Dr Ste 303
Naperville, IL 60563-9792

Mailing address

636 Raymond Dr Ste 303
Naperville, IL 60563-9792
Phone (630) 653-4240

Other practice location 1

1800 N Main St Ste 100
Wheaton, IL 60187-3112
Phone (630) 653-4240

Other practice location 2

885 Roosevelt Rd Ste 102
Glen Ellyn, IL 60137-6141
Phone (630) 653-4240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811000863 IL Practitioner - Obstetrics/Gynecology 7517185390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

636 Raymond Dr
Naperville, IL 60563-9789
Phone (630) 315-6500

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-05216IAMDObstetrics & Gynecology Physician
036157477ILMDObstetrics & Gynecology Physician
TEP7304NEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jul 19, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 19, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

885 Roosevelt Rd
Ste 102
Glen Ellyn, IL 60137
Phone (630) 545-3760

285 Roosevelt Rd
Glen Ellyn, IL 60137
Phone (630) 469-0045

636 Raymond Dr
Naperville, IL 60563
Phone (630) 355-5302

636 Raymond Dr
Ste 303
Naperville, IL 60563
Phone (630) 357-6540

1800 N Main St
Ste 100
Wheaton, IL 60187

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1104231620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 303",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 303",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-1505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 N Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601873112",
            "country_code": "US",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-6557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "885 Roosevelt Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Glen Ellyn",
            "state": "IL",
            "postal_code": "601376141",
            "country_code": "US",
            "telephone_number": "630-653-4240",
            "fax_number": "630-933-4581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEER PELLETIER",
        "first_name": "MELISSA",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "TEP7304",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "DO-05216",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036157477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.