Individual provider Active NPI

Melissa Ray

  • Family Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1831055904
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95038119 Issued in CA
Practice address
11 Avenida Fortuna
San Clemente, CA 92673-3252
Phone
(213) 910-5187
NPI assigned
Jan 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95038119 CA Primary

Addresses

Primary practice location

11 Avenida Fortuna
San Clemente, CA 92673-3252

Mailing address

11 Avenida Fortuna
San Clemente, CA 92673-3252

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260413000635 CA Practitioner - Nurse Practitioner 2062987514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2501 W Burbank Blvd
Suite 200
Burbank, CA 91505-2347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95038119CAMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1767225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1831055904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 AVENIDA FORTUNA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 AVENIDA FORTUNA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733252",
            "telephone_number": "213-910-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-01",
        "last_updated": "2026-01-01",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95038119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.