Individual provider Active NPI

Melissa Polk, OD

  • Optometrist
  • El Dorado, AR
National Provider Identifier
1992431597
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4049 Issued in AR
Practice address
310 Thompson Ave
El Dorado, AR 71730-4569
Phone
(870) 862-4216
Fax
(870) 862-2423
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4049 AR Primary

Addresses

Primary practice location

310 Thompson Ave
El Dorado, AR 71730-4569

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220816002489 LA Practitioner - Optometry 8426431917 Reassigns benefits to 1 organization
I20250925004252 AR Practitioner - Optometry 8426431917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

310 Thompson Ave
El Dorado, AR 71730-4569
Phone (870) 862-4216

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Oct 6, 2025 Accepting new patients
William D. Gordon, O.D. Inc. Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Family Eye Care Associates Optometrist CurrentSince Jul 13, 2025 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest PLLC Optometrist CurrentSince Oct 6, 2025 Accepting new patients

Locations

310 Thompson Ave
El Dorado, AR 71730
Phone (870) 862-4216

114 E 49th St
Texarkana, AR 71854
Phone (870) 774-2020

3000 Forsythe Ave
Monroe, LA 71201
Phone (318) 325-9474

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1992431597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 THOMPSON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304569",
            "telephone_number": "870-862-4216",
            "fax_number": "870-862-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "MELISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "4049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.