Individual provider Active NPI

Martin W Mizener, MD

  • Ophthalmology Physician
  • Omaha, NE
National Provider Identifier
1316929383
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20146 Issued in NE
Practice address
4353 Dodge St
Omaha, NE 68131-2709
Phone
(402) 552-2020
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 29056 IA
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 20146 NE
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 29056 IA
Ophthalmology Physician 207W00000X 20146 NE Primary

Addresses

Primary practice location

4353 Dodge St
Omaha, NE 68131-2709

Mailing address

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Other identifiers 1

IdentifierTypeStateIssuer
47080542812MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100521000429 IA Practitioner - Ophthalmology 0143362129 Reassigns benefits to 1 organization
I20100521000584 NE Practitioner - Ophthalmology 0143362129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Care PCGroup PAC ID 8628960572, 24 clinicians

Practice addresses (Care Compare)

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

715 Harmony St
Suite 300
Council Bluffs, IA 51503-3147
Phone (402) 552-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.02 of 100Reported as group
Quality
65.69
Promoting interoperability
89
Improvement activities
40
Cost
70.2

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20146NEMDOphthalmology Physician
29056IAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Care PC CurrentSince May 1, 2003 Accepting new patients
Midwest Eye Care, PC Ophthalmology CurrentSince May 1, 2003 Accepting new patients
Physicians Clinic Inc Past Accepting new patients
Midwest Eye Care, PC Ophthalmology Past Accepting new patients

Locations

715 Harmony St
Ste 300
Council Bluffs, IA 51503
Phone (712) 388-2600

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

4353 Dodge St
Omaha, NE 68131
Phone (402) 502-5599

Organizations & group practices 4

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1316929383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZENER",
        "first_name": "MARTIN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "29056",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "NE",
            "license": "20146",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "IA",
            "license": "29056",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NE",
            "license": "20146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080542812",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.