Mark G Mishak II, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

561 N Graham St
Stephenville, TX 76401-3548

Phone

(254) 965-2663

Fax

(254) 968-5912

NPI assigned

Aug 15, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmishak808961@direct.childrens.com

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.

• Doctx3 PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1467808618
  Medicare reassignment NPD
• Cross Timbers Imaging

  • Radiology Clinic/Center
  • Stephenville, TX
  • NPI 1043648215
  NPD (past)
• Ouch (Orthopedic Urgent Care Home, PLLC)

  • Pediatric Orthopaedic Surgery Physician
  • Southlake, TX
  • NPI 1427429869
  NPD (past)

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1114573144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764010014",
            "telephone_number": "254-965-2663",
            "fax_number": "254-968-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 N GRAHAM ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013548",
            "telephone_number": "254-965-2663",
            "fax_number": "254-968-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHAK",
        "first_name": "MARK",
        "middle_name": "G",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Argenis Merino Morales
• Elizabeth V. Mewhinney, LPC
• Miller Pediatrics, P.a.
• Kelly Miller, D.O.
• Melissa Mincy
• Laura Montgomery, OTR
• Luke Montgomery, ACT, LAT
• Monty Joshua Montgomery
• Casey Montoya
• Monty Banks OD PA

• Physician Assistant in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.