Individual provider Active NPI

Mark A Kornaus, OD

  • Optometrist
  • Madison, WI
National Provider Identifier
1215993530
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2011-035 Issued in WI
Practice address
1821 S Stoughton Rd
Madison, WI 53716-2257
Phone
(608) 260-6000
Fax
(608) 260-6716
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2011-035 WI Primary

Addresses

Primary practice location

1821 S Stoughton Rd
Madison, WI 53716-2257

Mailing address

1821 S Stoughton Rd
Dean Medical Center
Madison, WI 53716-2257
Phone (608) 260-6000

Other identifiers 1

IdentifierTypeStateIssuer
1215993530MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkornaus263495@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100625000636 WI Practitioner - Optometry 2567593171 Reassigns benefits to 1 organization
I20240808001405 AZ Practitioner - Optometry 2567593171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Eye Center LTDGroup PAC ID 1850296989, 116 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1121 S Gilbert Rd
Suite 103
Mesa, AZ 85204-5235
Phone (480) 854-3310

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

4760 E Falcon Dr
Suite 101
Mesa, AZ 85215-2528
Phone (480) 985-7400

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

752 N High Point Rd
Madison, WI 53717-2236
Phone (608) 824-4000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011-035WIMDOptometrist
2011WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnet Dulaney Perkins Eye Center, PC Current Accepting new patients
Southwestern Eye Center LTD CurrentSince Aug 1, 2024 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Aug 1, 2024 Accepting new patients
Dean Health Systems, Inc CurrentSince Oct 26, 2013 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Aug 1, 2024 Accepting new patients
Southwestern Eye Center, LTD Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 26, 2013 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Past Accepting new patients

Locations

110 S Idaho Rd
Ste 160
Apache Junction, AZ 85119
Phone (480) 982-0241

3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555

371 W Central Ave
Coolidge, AZ 85128
Phone (520) 723-3000

270 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-4202

520 S Hill St
Globe, AZ 85501
Phone (928) 425-8989

1151 S La Canada Dr
Ste 200
Green Valley, AZ 85614
Phone (520) 625-8562

6705 E McDowell Rd
Mesa, AZ 85215
Phone (480) 985-7400

1055 S Stapley Dr
Mesa, AZ 85204
Phone (480) 833-9100

1121 S Gilbert Rd
Ste 103
Mesa, AZ 85204
Phone (480) 459-8500

4760 E Falcon Dr
Ste 101
Mesa, AZ 85215
Phone (480) 985-7400

4800 N 22nd St
Phoenix, AZ 85016
Phone (602) 508-4843

4800 N 22nd St
Ste 120
Phoenix, AZ 85016

825 S 20th Ave
Safford, AZ 85546
Phone (928) 428-6930

2370 W State Route 89A
Ste 16A17A18
Sedona, AZ 86336
Phone (928) 282-1231

63 S Rockford Dr
Ste 220
Tempe, AZ 85288

5632 E 5th St
Tucson, AZ 85711
Phone (520) 584-8888

698 E Wetmore Rd
Ste 100
Tucson, AZ 85705
Phone (520) 690-5707

2149 W 24th St
Yuma, AZ 85364
Phone (928) 726-1100

275 W 28th St
Yuma, AZ 85364
Phone (928) 329-5011

1821 S Stoughton Rd
Madison, WI 53716
Phone (608) 260-6000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: mark.kornaus.p11@direct.avp.nextgenshare.com
  • Direct secure messaging: mark.kornaus.p20@direct.avp.nextgenshare.com

Organizations & group practices 8

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1215993530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 S STOUGHTON RD",
            "address_2": "DEAN MEDICAL CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162257",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S STOUGHTON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162257",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNAUS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2011-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215993530",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkornaus263495@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mkornaus263495@direct-ehr-ssmhc.com",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.