MELISSA DAWN SLACK (APRN) – Family Medicine Physician, NPI 1265103261
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for MELISSA DAWN SLACK (APRN)
12134 OLD DAYTON RD
BROOKVILLE, OH 453098361
Phone: (937) 416-8874
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $501.
Total Amount is formed as General ($501) + Research ($0) + Ownership ($0) = $501.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Kerecis Limited ($281).
Total Amount
$501
General + Research + Ownership
Payments
12
Total payment records
General Amount
$501
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $281 |
| Smith+Nephew, Inc. | $125 |
| Organogenesis Inc. | $52 |
| Integra LifeSciences Corporation | $28 |
| Solventum Corporation | $14 |
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: 2023-12-13
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 |
|---|---|---|---|---|
| I20211206001404 | I | Nurse Practitioner | OH | TBD |
| I20231213000303 | I | Nurse Practitioner | IN | 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 |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 232 | 69 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 93 | 49 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 84 | 47 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 61 | 61 | $0 |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 49 | 13 | $0 |
Insurance plans in this area (ZIP 45309)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | FL | |
| - | OH |
Reviews
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