Individual provider Active NPI

Mellinda Stewart, OD

  • Optometrist
  • Rogers, AR
National Provider Identifier
1104490044
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10339T Issued in TX
Practice address
3737 W Walnut St
Rogers, AR 72756-1839
Phone
(479) 246-1700
NPI assigned
May 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10339T TX Primary

Addresses

Primary practice location

3737 W Walnut St
Rogers, AR 72756-1839

Mailing address

4114 Medical Dr Apt 23303
San Antonio, TX 78229-5669
Phone (254) 289-6903

Other practice location 1

25 Cunningham Cor
Bella Vista, AR 72714-3520
Phone (479) 256-1700

Other identifiers 1

IdentifierTypeStateIssuer
2853OtherARARKANSAS BOARD OF OPTOMETRY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20220808000830 AR Practitioner - Optometry 9234511270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boozman-Hof Regional Eye Clinic PAGroup PAC ID 4981628245, 12 clinicians

Practice addresses (Care Compare)

25 Cunningham Cor
Bella Vista, AR 72714-3520
Phone (479) 268-4047

Merit-based Incentive Payment System (MIPS)

Final score
92.75 of 100Reported as group
Quality
99.17
Improvement activities
40
Cost
76.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10339TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Boozman-Hof Regional Eye Clinic PA Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Boozman-Hof Regional Eye Clinic Optometrist Past Accepting new patients

Locations

25 Cunningham Cor
Bella Vista, AR 72714
Phone (479) 246-1700

3737 W Walnut St
Rogers, AR 72756
Phone (479) 246-1700

Interoperability endpoints

  • Direct secure messaging: mstewart@bhrec.intellechartdirect.net

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": "1621036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1104490044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 MEDICAL DR APT 23303",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295669",
            "telephone_number": "254-289-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727561839",
            "telephone_number": "479-246-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Cunningham Cor",
            "address_purpose": "LOCATION",
            "city": "Bella Vista",
            "state": "AR",
            "postal_code": "727143520",
            "country_code": "US",
            "telephone_number": "479-256-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MELLINDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-15",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10339T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BOARD OF OPTOMETRY",
            "identifier": "2853",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.