MELISSA MARIE PANNELL (RN FNP-BC) – Family Nurse Practitioner, NPI 1053756403
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,509 NURSE PRACTITIONER in AZ
Provider Addresses for MELISSA MARIE PANNELL (RN FNP-BC)
13203 N 103RD AVE STE H5
SUN CITY, AZ 853513032
Phone: (623) 777-4747
Fax: (623) 777-4748
Type: Mailing
3645 S Rome St Ste 204
Gilbert, AZ 85297
Phone: (623) 777-4747
Type: Location
3280 E Lanark Dr
Meridian, ID 836425982
Phone: (208) 895-8670
Fax: (208) 955-0494
Type: Location
3645 S ROME ST STE 204
GILBERT, AZ 85297
Phone: (623) 777-4747
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140519002001 | I | Nurse Practitioner | AZ | TBD |
| I20251027003926 | I | Nurse Practitioner | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 85351)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | NM | |
| Physician Assistant | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ |
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