Individual provider Active NPI

Daniel Scott Mlnarik, O.D.

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1205240256
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004829 Issued in MI
Practice address
2860 E Beltline Ave NE
Grand Rapids, MI 49525-9704
Phone
(616) 364-8484
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004829 MI Primary

Addresses

Primary practice location

2860 E Beltline Ave NE
Grand Rapids, MI 49525-9704

Mailing address

2221 Van Dyke St
Conklin, MI 49403-9597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708000840 MI Practitioner - Optometry 5496067282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

2221 Health Dr SW
Suite 1100
Wyoming, MI 49519-9650
Phone (616) 252-5710

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004829MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Jun 1, 2017 Accepting new patients
Cutlerville Eyecare, P.C. Optometrist CurrentSince Oct 3, 2017 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

6680 Division Ave S
Grand Rapids, MI 49548
Phone (616) 455-2525

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

2221 Health Dr SW
Ste 1100
Wyoming, MI 49519
Phone (616) 252-5710

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: dmlnarik76122@direct.metrohealth.net

Organizations & group practices 3

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 1

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1205240256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 VAN DYKE ST",
            "city": "CONKLIN",
            "state": "MI",
            "postal_code": "494039597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259704",
            "telephone_number": "616-364-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLNARIK",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.