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 La Laser Center Pc A Professional Medical Corporation, La Laser Center Pc A Professional Medical Corporation, Sanford Medical Center Fargo 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. |
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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: 05/30/2025
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 |
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| 1588989412 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 70096 (Arizona) | Secondary |
| 207N00000X | Dermatology | 22506 (North Dakota) | Secondary |
| 207N00000X | Dermatology | A168938 (California) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 70096 (Arizona) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | A168938 (California) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | A168938 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| La Laser Center Pc A Professional Medical Corporation | 9537181185 | 82 |
| La Laser Center Pc A Professional Medical Corporation | 9537181185 | 82 |
| Sanford Medical Center Fargo | 8426967803 | 1125 |
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 | La Laser Center Pc A Professional Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306982855
PECOS PAC ID: 9537181185
Enrollment ID: O20051222000459 |
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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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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 |
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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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