Individual provider Active NPI

Michael Alexander Sywak, MD

  • Vascular Surgery Physician
  • Cookeville, TN
National Provider Identifier
1003104639
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
58850 Issued in TN
Practice address
222 W 4TH St Ste 201
Cookeville, TN 38501-2413
Phone
(931) 783-4269
Fax
(931) 372-0401
NPI assigned
Jul 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 58850 TN Primary

Addresses

Primary practice location

222 W 4TH St Ste 201
Cookeville, TN 38501-2413

Mailing address

140 W 7TH St
Cookeville, TN 38501-1726
Phone (931) 783-5582

Other identifiers 1

IdentifierTypeStateIssuer
Q050621MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190809000262 TN Practitioner - Vascular Surgery 2365780954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Regional Medical Group IncGroup PAC ID 8325092638, 54 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-5857

100 W 4TH St
Suite 350
Cookeville, TN 38501-4225
Phone (931) 783-2753

Hospital & facility affiliations

  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Merit-based Incentive Payment System (MIPS)

Final score
92.03 of 100Reported as individual
Quality
73.93
Promoting interoperability
99
Improvement activities
40
Cost
83.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cookeville Regional Medical Group, Inc CurrentSince Aug 1, 2019 Accepting new patients

Locations

406 N Whitney Ave
Ste 5
Cookeville, TN 38501
Phone (931) 783-2904

100 W 4th St
Ste 350
Cookeville, TN 38501
Phone (931) 646-2901

127 N Oak Ave
#D
Cookeville, TN 38501

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

228 W 4th St
Ste 301
Cookeville, TN 38501
Phone (931) 526-4349

Interoperability endpoints

  • Direct secure messaging: michael.sywak.1@10383.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1003104639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-783-5582",
            "fax_number": "931-526-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 4TH ST STE 201",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012413",
            "telephone_number": "931-783-4269",
            "fax_number": "931-372-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYWAK",
        "first_name": "MICHAEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "58850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q050621",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.