Melissa Sample, FNP - Medicare Nurse Practitioner in Chiloquin, OR

  1. Home
  2. Nurse Practitioner
  3. OR
  4. Chiloquin
Melissa Sample, FNP is a medicare enrolled "Nurse Practitioner - Family" in Chiloquin, Oregon. She graduated from nursing school in 2008 and has 18 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Icco Llc and her current practice location is 103 Waso, Chiloquin, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 880-2011.

Melissa Sample is licensed to practice in Oregon (license number 200850150NP) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922250364.

Contact Information

Melissa Sample, FNP
103 Waso,
Chiloquin, OR 97624
(541) 880-2011
(541) 783-3273

Map and Direction




Provider's Profile

Full NameMelissa Sample
GenderFemale
SpecialityNurse Practitioner
Experience18 Years
Location103 Waso, Chiloquin, Oregon
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Melissa Sample graduated from nursing school in 2008
  NPI Data:
  • NPI Number: 1922250364
  • Provider Enumeration Date: 10/16/2008
  • Last Update Date: 01/15/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 4183760424
  • Enrollment ID: I20090930000264

Medical Identifiers

Medical identifiers for Melissa Sample such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1922250364NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 099000635RN (Oregon)Secondary
363LF0000XNurse Practitioner - Family 200850150NP (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Willamette Valley Medical CenterMcminnville, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Icco Llc1355406729108

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Melissa Sample allows following entities to bill medicare on her behalf.
Entity NameSky Lakes Medical Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659340370
PECOS PAC ID: 1052204096
Enrollment ID: O20040204000577
Entity NameIcco Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407004757
PECOS PAC ID: 1355406729
Enrollment ID: O20090218000510

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Melissa Sample is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Melissa Sample, FNP
2074 S 6th St,
Klamath Falls, OR 97601-3372

Ph: (541) 880-2011		Melissa Sample, FNP
103 Waso,
Chiloquin, OR 97624

Ph: (541) 880-2011

Reviews and Comments


Nurse Practitioner Nurses in Chiloquin, OR

Andrew J Hughes, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624
Phone: 800-246-7894    Fax: 541-783-2028
Ms. Elizabeth Burton Matuk, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 330 S Chiloquin Blvd, Chiloquin, OR 97624
Phone: 541-783-3293    Fax: 541-783-3273
Christina M Hughes, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624
Phone: 800-246-7894    Fax: 541-783-2028
Crystal Nathalia Novelozo, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624
Phone: 541-882-1487    Fax: 541-783-3237

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.