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Individual provider Active NPI

Melissa Nicole Wollmer

  • Obstetrics Physician
  • Albany, OR
National Provider Identifier
1821591850
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
DO221057 Issued in OR
Practice address
705 Elm St SW Ste 200
Albany, OR 97321-1957
Phone
(541) 812-4850
NPI assigned
Mar 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics Physician 207VX0000X DO221057 OR Primary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 5151014516 MI

Addresses

Primary practice location

705 Elm St SW Ste 200
Albany, OR 97321-1957

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3297

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwollmer287115@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240812001126 OR Practitioner - Obstetrics/Gynecology 5597187732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Col of Osteo Med of the Pacific at Lebanon, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022
  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Sep 9, 2024 Accepting new patients
Albany General Hospital Single Specialty Current Accepting new patients
Albany General Hospital CurrentSince Sep 9, 2024 Accepting new patients
Western University of Health Sciences Past Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

Organizations & group practices 4

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1821591850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 ELM ST SW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211957",
            "telephone_number": "541-812-4850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5450 Fort St",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481834601",
            "country_code": "US",
            "telephone_number": "734-671-3297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLLMER",
        "first_name": "MELISSA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OR",
            "license": "DO221057",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5151014516",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwollmer287115@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "705 Elm St SW Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.