Individual provider Active NPI

Melissa A Beaty, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1265631139
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
580 Issued in NV
Practice address
9011 W Sahara Ave
Suite 101
Las Vegas, NV 89117-4800
Phone
(702) 792-3937
Fax
(702) 732-4108
NPI assigned
Jul 12, 2007
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 580 NV Primary

Addresses

Primary practice location

9011 W Sahara Ave
Suite 101
Las Vegas, NV 89117-4800

Mailing address

9011 W. Sahara Avenue
Suite 101
Las Vegas, NV 89117-4801
Phone (702) 792-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20071004000505 NV Practitioner - Optometry 9335232305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 N Nellis Blvd
Suite 130
Las Vegas, NV 89110-6010
Phone (702) 820-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
580NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vegas Optics, LLC Optometrist CurrentSince Sep 1, 2015 Accepting new patients
Optic Gallery Nellis LLC Optometrist CurrentSince Jun 21, 2018 Accepting new patients
Romy Park OD Professional Corporation Optometrist CurrentSince Aug 21, 2012 Accepting new patients
Dynamic Eye Care Optometrist PastSince Apr 1, 2016 Accepting new patients
Eyedocs Care LLC Optometrist Past Accepting new patients
Stephen J Chiarello LTD PastSince Oct 1, 2013 Accepting new patients

Locations

111 N Nellis Blvd
Ste 130
Las Vegas, NV 89110
Phone (702) 820-2020

2595 S Maryland Pkwy
Ste 106
Las Vegas, NV 89109
Phone (702) 220-9767

3615 S Rainbow Blvd
Ste 1
Las Vegas, NV 89103
Phone (702) 641-2007

3900 Spring Mountain Rd
#A1
Las Vegas, NV 89102
Phone (702) 641-2007

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1265631139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 W. SAHARA AVENUE",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174801",
            "telephone_number": "702-792-3937",
            "fax_number": "702-732-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 W SAHARA AVE",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174800",
            "telephone_number": "702-792-3937",
            "fax_number": "702-732-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATY",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.