Individual provider Active NPI

Melissa Ayn Meyer, M.D.

  • Family Medicine Physician
  • Port Orchard, WA
National Provider Identifier
1083691059
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00048156 Issued in WA
Practice address
1141 Beach Dr E
Port Orchard, WA 98366-4937
Phone
(360) 895-4680
Fax
(360) 895-4709
NPI assigned
Dec 29, 2005
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00048156 WA Primary

Addresses

Primary practice location

1141 Beach Dr E
Port Orchard, WA 98366-4937

Mailing address

1141 Beach Dr E
Port Orchard, WA 98366-4937
Phone (360) 895-4680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 29, 2021 through Dec 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00048156WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1083691059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 BEACH DR E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664937",
            "telephone_number": "360-895-4680",
            "fax_number": "360-895-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 BEACH DR E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664937",
            "telephone_number": "360-895-4680",
            "fax_number": "360-895-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MELISSA",
        "middle_name": "AYN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00048156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.