Misty Mello, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35803 Issued in CA

Practice address

12300 Seal Beach Blvd
Seal Beach, CA 90740-2709

Phone

(562) 594-5546

NPI assigned

Jul 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Misty Claire Perez Mello Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mai Tang OD, Inc

  • Optometrist
  • Fullerton, CA
  • NPI 1316206550
  Medicare reassignment NPD

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1477391605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19327 ACKERMAN AVE",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212119",
            "telephone_number": "858-386-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 SEAL BEACH BLVD",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402709",
            "telephone_number": "562-594-5546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 W Town and Country Rd Unit 458",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928685662",
            "country_code": "US",
            "telephone_number": "858-386-6241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLO",
        "first_name": "MISTY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY CLAIRE",
            "last_name": "MELLO",
            "middle_name": "PEREZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John James McEachin, PH.D.
• Laura L McEwan, RN, MSN,FNP-BC
• Medcare Medical RX Inc
• Nibedita Medhi
• Javier A Mejia, DDS
• Lorna Jean Metzger, RN
• Elizabeth Grace Middleton, M.A. MFT 48766
• Staci Miller
• Christine Milne-Seminara, BCBA
• Brianna Mondy

• Optometrist in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.