MELANIE CODERRE (PA-C) – Surgical Physician Assistant, NPI 1245760891
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for MELANIE CODERRE (PA-C)
Golf Road, Skokie, Niles Township, Cook County, Illinois, 60025, United States
SKOKIE, IL 600761262
Phone: (847) 869-7233
Type: Mailing
2850 S WABASH AVE STE 100
CHICAGO, IL 606162491
Phone: (312) 842-4600
Type: Mailing
2850 S WABASH AVE
CHICAGO, IL 606162955
Phone: (312) 842-4600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $773.
Total Amount is formed as General ($773) + Research ($0) + Ownership ($0) = $773.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Lightbody Medical Technologies Inc ($552).
Total Amount
$773
General + Research + Ownership
Payments
11
Total payment records
General Amount
$773
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lightbody Medical Technologies Inc | $552 |
| Arthrex, Inc. | $173 |
| Vericel Corporation | $25 |
| SANOFI-AVENTIS U.S. LLC | $23 |
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: 2017-08-10
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 |
|---|---|---|---|---|
| I20170810002780 | I | Physician Assistant | IL | 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 60076)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| Orthopedic Surgery | IL | |
| Physical Therapist In Private Practice | IL | |
| P O D I A T R Y | IL | |
| Orthopedic Surgery | IL | |
| Physician Assistant | IL | |
| Physical Therapist In Private Practice | IL | |
| Orthopedic Surgery | IL | |
| Orthopedic Surgery | IL | |
| Physician Assistant | IL |
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