Individual provider Active NPI

Melanie Renae Johnson, PA-C

  • Medical Physician Assistant
  • Saint Marys, PA
National Provider Identifier
1831590363
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA056954 Issued in PA
Practice address
761 Johnsonburg Rd
Suite #160
Saint Marys, PA 15857-3483
Phone
(814) 788-8777
Fax
(814) 788-8770
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056954 PA Primary
Physician Assistant 363A00000X OA003330 PA

Addresses

Primary practice location

761 Johnsonburg Rd
Suite #160
Saint Marys, PA 15857-3483

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4200

Other identifiers 1

IdentifierTypeStateIssuer
103146235MedicaidPA

Other names 1

  • Miss Melanie Renae Riglin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150318000702 PA Practitioner - Physician Assistant 4880911528 Reassigns benefits to 4 organizations
I20231005001091 NY Practitioner - Physician Assistant 4880911528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

26 Bolivar Dr
Bradford, PA 16701-3125
Phone (814) 817-4690

655 E Dubois Ave
Du Bois, PA 15801-3605
Phone (814) 913-3097

917 S Saint Marys St
Saint Marys, PA 15857-2828
Phone (814) 389-1026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA003330PAMDPhysician Assistant
MA056954PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Physician Assistant CurrentSince Nov 19, 2014 Accepting new patients
Elk Regional Health Center CurrentSince Nov 1, 2020 Accepting new patients
Dubois Regional Medical Center CurrentSince Nov 19, 2014 Accepting new patients
Elk Regional Health Center Physician Assistant CurrentSince Nov 1, 2020 Accepting new patients
Dubois Regional Medical Center CurrentSince Nov 19, 2014 Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

145 Hospital Ave
Ste 204
Dubois, PA 15801
Phone (814) 371-4360

111 Cobb St
Johnsonburg, PA 15845
Phone (814) 965-2857

761 Johnsonburg Rd
Ste 160
Saint Marys, PA 15857
Phone (814) 788-8777

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1831590363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG RD",
            "address_2": "SUITE #160",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573483",
            "telephone_number": "814-788-8777",
            "fax_number": "814-788-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELANIE",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056954",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003330",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103146235",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "RIGLIN",
            "middle_name": "RENAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Marys, PA

Sources for this page

Verify at the official NPI Registry.