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MELISSA MAE MOUTRAY MD DDS
NPI 1386963718
Oral & Maxillofacial Surgery in Garden City, KS

Active since May 25, 2010Opted out of Medicare · through Jun 17, 2028
311 CAMPUS DRIVE, SUITE 101, GARDEN CITY, KS 67846(602) 272-0100(620) 271-0160 Get Directions Write a Review

NPPES record last updated: July 15, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 15, 2021, Sep 4, 2020, Jun 24, 2016 (3 updates tracked since 2016).

About Melissa Mae Moutray Md Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELISSA MAE MOUTRAY MD DDS (NPI 1386963718) is an individual oral & maxillofacial surgery provider in Garden City, Kansas, licensed in Kansas (04-41292) and active in the NPI registry since May 2010. She has opted out of Medicare through June 17, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1386963718
Entity TypeIndividualFemale
Primary Taxonomy204E00000X
Provider Legal NameMELISSA MAE MOUTRAYCredential: MD DDS
Location Address311 CAMPUS DRIVE, SUITE 101Garden City, KS 67846
Mailing Address311 Campus Drive, Suite 101Garden City, KS 67846 · (602) 272-0100 · Fax (620) 271-0160
Phone(602) 272-0100
Fax(620) 271-0160
Sole ProprietorNo
Enumeration DateMay 25, 2010
Last NPPES UpdateJuly 15, 20213 updates tracked since enumeration
NPPES CertifiedJuly 15, 2021
✔ NPI 1386963718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Licenses✔ Licensed in KS · 04-41292✔ Licensed in SD · D1107
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
311 CAMPUS DRIVE, Garden City, KS 67846
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Melissa Mae Moutray Md Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 17, 2016 through June 17, 2028.

Opt-Out Effective DateJune 17, 2016
Opt-Out In Effect ThroughJune 17, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RONALD L. ROHOLT DDS, MD
Dentist (Oral and Maxillofacial Surgery)
311 CAMPUS DRIVE, SUITE 101
GARDEN CITY, KS 67846
Finney County (620) 272-0100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Melissa Moutray's NPI number?

The NPI number for Melissa Moutray is 1386963718. It was assigned to this individual provider in the NPPES registry on May 25, 2010.

Where is Melissa Moutray located?

Melissa Moutray practices at 311 Campus Drive Suite 101, Garden City, KS 67846. The listed phone number is (602) 272-0100.

What is Melissa Moutray's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Melissa Moutray enrolled in Medicare?

No. Melissa Moutray has opted out of Medicare through June 17, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Melissa Moutray accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Nebraska and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Melissa Moutray as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Melissa Moutray was last updated on July 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.