MRS. MELANIE JEAN KOUMENTAKOS (PA C) – Physician Assistant, NPI 1295925956
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,244 PHYSICIAN ASSISTANT in CT
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Provider Addresses for MRS. MELANIE JEAN KOUMENTAKOS (PA C)
113, Elm Street, Enfield, White County, Illinois, 62835, United States
SUITE 304
ENFIELD, CT 06082
Phone: (860) 741-2225
Fax: (860) 741-2229
Type: Location
200 SILVER ST UNIT 106
AGAWAM, MA 010013067
Phone: (413) 341-5350
Fax: (413) 341-5335
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 456 Open Payments records for all available years, with a total value of $10,565.
Total Amount is formed as General ($10,565) + Research ($0) + Ownership ($0) = $10,565.
Last reported payment date: 2024-12-29 • Largest payer in this snapshot: ABBVIE INC. ($2,355).
Total Amount
$10,565
General + Research + Ownership
Payments
456
Total payment records
General Amount
$10,565
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $2,355 |
| E.R. Squibb & Sons, L.L.C. | $1,354 |
| UCB, Inc. | $1,029 |
| Lilly USA, LLC | $781 |
| Janssen Biotech, Inc. | $568 |
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: 2017-01-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20170124001990 | I | Physician Assistant | MA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 135 | 31 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 104 | 102 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 92 | 92 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 90 | 90 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 60 | 38 | $0 |
Insurance plans in this area (ZIP 06082)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MA | |
| Physician Assistant | MA | |
| D E R M A T O L O G Y | MA | |
| Physician Assistant | MA | |
| Physician Assistant | CT | |
| Nurse Practitioner | MA |
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