Individual provider Active NPI

Melanie A Pergiel, ANP

  • Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1508830613
Registry record updated Apr 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28232238B Issued in IN
Practice address
701 Wall St
Valparaiso, IN 46383-2514
Phone
(219) 413-5100
Fax
(219) 465-9502
NPI assigned
Feb 15, 2006
Last updated
Apr 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28232238B IN Primary
Registered Nurse 163W00000X 28232238A IN
General Practice Registered Nurse 163WG0000X RN069666 AZ

Addresses

Primary practice location

701 Wall St
Valparaiso, IN 46383-2514

Mailing address

701 Wall St
Valparaiso, IN 46383-2514
Phone (219) 413-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28232238AINMDRegistered Nurse
RN069666AZMDGeneral Practice Registered Nurse
28232238BINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Imaging Associates, LLC Past Accepting new patients
Bristol Bay Borough Past Accepting new patients
Camai Community Health Center, Inc. PastSince Sep 6, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20726/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melanie.pergiel@37705406676996.direct.elationemr.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492300800000",
    "number": "1508830613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832514",
            "telephone_number": "219-413-5100",
            "fax_number": "219-465-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832514",
            "telephone_number": "219-413-5100",
            "fax_number": "219-465-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERGIEL",
        "first_name": "MELANIE",
        "middle_name": "A",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2017-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28232238B",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28232238A",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AZ",
            "license": "RN069666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.