NPIMap

Individual provider Active NPI

Melissa J McIntosh, M.D.

  • Internal Medicine Physician
  • Independence, KS
National Provider Identifier
1366465817
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-29443 Issued in KS
Practice address
510 Peter Pan Rd
Independence, KS 67301-7300
Phone
(620) 577-4310
Fax
(620) 577-4312
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 04-29443 KS
Internal Medicine Physician 207R00000X 04-29443 KS Primary

Addresses

Primary practice location

510 Peter Pan Rd
Independence, KS 67301-7300

Mailing address

PO Box 736
Parsons, KS 67357-0736
Phone (620) 820-5428

Other practice location 1

1020 Lenape Dr
Nowata, OK 74048-4403
Phone (918) 273-7500

Other identifiers 4

IdentifierTypeStateIssuer
100412310AMedicaidKS
100229360AOtherOKOKLAHOMA MEDICAID
101724OtherKSBLUE CROSS BLUE SHIELD
110236310OtherKSTRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100505000203 KS Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4486782950 Reassigns benefits to 2 organizations
I20120228000558 TX Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4486782950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osage Nation Si-Si a-Pe-TxaGroup PAC ID 2769847912, 13 clinicians

Practice addresses (Care Compare)

715 Grandview Ave
Pawhuska, OK 74056-3201
Phone (918) 287-9335

Hospital & facility affiliations

  • Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
  • Shanadoa Home Health, Inc. Home health agency, Tulsa, OK, CCN 377733
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Pawhuska Hospital, Inc Hospital, Pawhuska, OK, CCN 371309

Merit-based Incentive Payment System (MIPS)

Final score
48.28 of 100Reported as group
Quality
21.69
Improvement activities
40
Cost
71.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jan 23, 2012 Accepting new patients
Labette County Medical Center Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jan 23, 2012 Accepting new patients
Labette County Medical Center CurrentSince Mar 1, 2017 Accepting new patients
Coffeyville Family Practice Clinic, P.a. Current Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Oct 1, 2015 Accepting new patients
Osage Nation Si-Si a-Pe-Txa CurrentSince Nov 15, 2023 Accepting new patients
Labette County Medical Center CurrentSince Mar 1, 2017 Accepting new patients
Labette County Medical Center Current Accepting new patients
Osage Nation Si-Si a-Pe-Txa Past Accepting new patients
Coffeyville Family Practice Clinic, P.a. PastSince Aug 1, 2002 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

209 W 7th St
Coffeyville, KS 67337
Phone (316) 251-1100

1400 W 4th St
Coffeyville, KS 67337
Phone (620) 251-1200

324 S Main St
Erie, KS 66733
Phone (620) 244-3291

510 Peter Pan Rd
Independence, KS 67301
Phone (620) 331-4099

1902 S US Highway 59
Parsons, KS 67357
Phone (620) 421-4880

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

715 Grandview Ave
Pawhuska, OK 74056
Phone (918) 287-4491

316 E Main St
Pawhuska, OK 74056
Phone (918) 287-9300

Dept 2269
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: mmcintosh@lh.gwaydirect.com
  • Direct secure messaging: melissa.mcintosh@khindirect.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1366465817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673570736",
            "telephone_number": "620-820-5428",
            "fax_number": "620-820-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PETER PAN RD",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673017300",
            "telephone_number": "620-577-4310",
            "fax_number": "620-577-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Lenape Dr",
            "address_purpose": "LOCATION",
            "city": "Nowata",
            "state": "OK",
            "postal_code": "740484403",
            "country_code": "US",
            "telephone_number": "918-273-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-29443",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-29443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100412310A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA MEDICAID",
            "identifier": "100229360A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "101724",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "110236310",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KS

Sources for this page

Verify at the official NPI Registry.