NPIMap

Individual provider Active NPI

Melissa Koppelman, DO

  • Family Medicine Physician
  • Thornville, OH
National Provider Identifier
1790225423
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.014432 Issued in OH
Practice address
41 Foster Dr
Thornville, OH 43076-8010
Phone
(740) 246-6361
Fax
(740) 246-5722
NPI assigned
Feb 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.014432 OH Primary

Addresses

Primary practice location

41 Foster Dr
Thornville, OH 43076-8010

Mailing address

41 Foster Dr
Thornville, OH 43076-8010
Phone (740) 246-6361

Other names 1

  • Melissa De Nijs Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200605001316 OH Practitioner - Family Practice 4183997877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Group of Southeastern Ohio IncGroup PAC ID 8628232469, 61 clinicians

Practice addresses (Care Compare)

41 Foster Dr
Thornville, OH 43076-8010
Phone (740) 455-3304

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Group of Southeastern Ohio Inc Family Medicine CurrentSince Jan 8, 2024 Accepting new patients
Thornville Family Medical Center Inc Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Medical Home Primary Care Center Family Medicine Current Accepting new patients

Locations

3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248

Interoperability endpoints

  • Direct secure messaging: melissa.koppelman.p16@direct.pgseo.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1790225423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 FOSTER DR",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430768010",
            "telephone_number": "740-246-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 FOSTER DR",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430768010",
            "telephone_number": "740-246-6361",
            "fax_number": "740-246-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPELMAN",
        "first_name": "MELISSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.014432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DE NIJS",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thornville, OH

Sources for this page

Verify at the official NPI Registry.