Shayna Mellesmoen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3883 Issued in MN

Practice address

9117 Lyndale Ave S
Bloomington, MN 55420-3522

Phone

(952) 835-1235

NPI assigned

Jun 29, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Visionary Eye Care PA 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.88 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.25

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Visionary Eye Care, PA

  • Optometrist
  • Excelsior, MN
  • NPI 1811430226

  MN, Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1104503382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 2ND AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201211",
            "telephone_number": "952-686-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9117 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203522",
            "telephone_number": "952-835-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLESMOEN",
        "first_name": "SHAYNA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Mejia
• Yohana Mekonnen
• Stephanie Melby, PHARMD
• Jill Suzanne Melicher Larson, MD
• Aimee Mona Meligy
• Abbey Mello, MD
• Rebecca J Mellstrom, LICSW
• Shamyra Tanay Melton
• Deanna Francesca Mendoza
• Lisa D Mendoza, LPCC

• All providers in Bloomington, MN
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.