Individual provider Active NPI

Melissa Ann Germundsen, OD

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1043883655
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34842 Issued in CA
Practice address
10088 Adams Ave
Huntington Beach, CA 92646-4905
Phone
(714) 962-9377
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34842 CA Primary

Addresses

Primary practice location

10088 Adams Ave
Huntington Beach, CA 92646-4905

Mailing address

18411 Santa Veronica Cir
Fountain Valley, CA 92708-5533
Phone (714) 625-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230602000500 CA Practitioner - Optometry 6406213685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beachside Optometry Germundsen-Family Partnership Optometrist CurrentSince Jul 25, 2021 Accepting new patients
Beachside Optometry Inc. Optometrist CurrentSince Apr 29, 2023 Accepting new patients

Locations

10088 Adams Ave
Huntington Beach, CA 92646
Phone (714) 962-9377

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1043883655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 SANTA VERONICA CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085533",
            "telephone_number": "714-625-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10088 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464905",
            "telephone_number": "714-962-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMUNDSEN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.