Active NPI
Mark Wayne Mutter II, OD
- Optometrist
- Missoula, MT
National Provider Identifier
1023690757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4079
- Practice address
- 700 W Kent Ave
Missoula, MT 59801-6772 - Phone
- (406) 541-3937
- Fax
- (406) 541-3811
- NPI assigned
- Apr 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4079 | MT | Primary |
Addresses
Primary practice location
700 W Kent Ave
Missoula, MT 59801-6772
Mailing address
700 W Kent Ave
Missoula, MT 59801-6772
Phone (406) 541-3937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 W Kent Ave
Missoula, MT 59801-6772
Phone (406) 541-3937
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.49 of 100
- Quality
- 86.46
- Promoting interoperability
- 95
- Improvement activities
- 40
- Cost
- 76
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4079 | MT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocky Mountain Eye Center PC | Optometrist | Current | Accepting new patients |
Locations
700 W Kent Ave
Missoula, MT 59801
Phone (406) 541-3277
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701993600000",
"number": "1023690757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W KENT AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598016772",
"telephone_number": "406-541-3937",
"fax_number": "406-541-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W KENT AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598016772",
"telephone_number": "406-541-3937",
"fax_number": "406-541-3811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTTER",
"first_name": "MARK",
"middle_name": "WAYNE",
"name_suffix": "II",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-22",
"last_updated": "2023-12-08",
"certification_date": "2023-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MT",
"license": "4079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.