Dr Misty Eleryan, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Marina Del Rey, California. She graduated from medical school in 2010 and has 15 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Csi Medical Group and her current practice location is
13157 Mindanao Way # 329, Marina Del Rey, California. You can reach out to her office (for appointments etc.) via phone at
(310) 564-2782.
Dr Misty Eleryan is licensed to practice in California (license number A168938) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1588989412.
Physician's Profile
Full Name | Dr Misty Eleryan |
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Gender | Female |
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Speciality | Dermatology |
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Experience | 15 Years |
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Location | 13157 Mindanao Way # 329, Marina Del Rey, California |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Misty Eleryan graduated from medical school in 2010
NPI Data:
- NPI Number: 1588989412
- Provider Enumeration Date: 04/04/2010
- Last Update Date: 10/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 6608031182
- Enrollment ID: I20220624000276
Medical Identifiers
Medical identifiers for Dr Misty Eleryan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1588989412 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | A168938 (California) | Secondary |
207ND0101X | Dermatology - Mohs-micrographic Surgery | A168938 (California) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Csi Medical Group | 5890916845 | 100 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Misty Eleryan allows following entities to bill medicare on her behalf.
Entity Name | Daniel Gene Kolder Md A California Professional Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598006652 PECOS PAC ID: 0143466870 Enrollment ID: O20130424000796 |
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Entity Name | Camarillo Surgical Center Associates Inc |
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Entity Type | Part B Supplier - Ambulatory Surgical Center |
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Entity Identifiers | NPI Number: 1801230719 PECOS PAC ID: 8224251616 Enrollment ID: O20140604000762 |
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Entity Name | Csi Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1871909804 PECOS PAC ID: 5890916845 Enrollment ID: O20141016001930 |
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Entity Name | Pacifica Dermatology |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497392492 PECOS PAC ID: 0840628533 Enrollment ID: O20200311001488 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Misty Eleryan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Misty Eleryan, MD 13157 Mindanao Way # 329, Marina Del Rey, CA 90292-6307 Ph: () - | Dr Misty Eleryan, MD 13157 Mindanao Way # 329, Marina Del Rey, CA 90292-6307 Ph: (310) 564-2782 |
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