Kevin A Mysliwiec, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1843 Issued in TN

Practice address

2523 Jacksboro Pike
Jacksboro, TN 37757-4847

Phone

(423) 566-2020

Fax

(423) 566-4245

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Eye Care IncGroup PAC ID 7012908643, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Associates in Eye Care, Inc.

  • Optometrist
  • Jellico, TN
  • NPI 1427149160
  Medicare reassignment Care Compare group NPD
• Associates in Eye Care, Inc.

  • Optometrist
  • Jacksboro, TN
  • NPI 1336230077
  Care Compare group
• Associates in Eye Care, Inc.

  • Optometrist
  • Somerset, KY
  • NPI 1649377177
  Care Compare group
• Associates in Eye Care, Inc.

  • Optometrist
  • Oneida, TN
  • NPI 1679664304
  NPD

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1275539736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FERGUSON",
            "state": "KY",
            "postal_code": "425330306",
            "telephone_number": "606-492-2211",
            "fax_number": "606-676-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 JACKSBORO PIKE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377574847",
            "telephone_number": "423-566-2020",
            "fax_number": "423-566-4245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2523 Jacksboro Pike",
            "address_purpose": "LOCATION",
            "city": "Jacksboro",
            "state": "TN",
            "postal_code": "37757",
            "country_code": "US",
            "telephone_number": "423-566-2020",
            "fax_number": "423-566-4245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16605 Alberta St",
            "address_purpose": "LOCATION",
            "city": "Oneida",
            "state": "TN",
            "postal_code": "378416283",
            "country_code": "US",
            "telephone_number": "423-569-9339",
            "fax_number": "423-569-1316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYSLIWIEC",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1843",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1429DT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000156",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941367",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE FOR JELLICO",
            "identifier": "410041149",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN/BLUECARE/TENNCARE",
            "identifier": "3090877; 3154561",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941364",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE FOR JACKSBORO",
            "identifier": "410036018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01260522",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE FOR ONEIDA",
            "identifier": "410047039",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "COMPULINK",
            "affiliation": "N",
            "endpointDescription": "SECURE SOFTWARE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC HEALTH RECORDS",
            "address_1": "16605 Alberta St",
            "city": "Oneida",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378416283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alissa Dower Miracle, PHARMD
• Mary Kate Moore, APRN, FNP-BC
• Jennifer Maria Muggridge, APRN
• Laura Kaleigh Mundy, FNP-BC
• Myeyedr Optometry of Tennessee, LLC
• Sandy L Mysliwiec, O.D.
• Gurpreet K Narula, M.D.
• Harjeet Narula, M.D.
• Tona A Neal, OD
• Neighborhood Medical LLC

• All providers in Jacksboro, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.

Verify at the official NPI Registry.