Mitchell Jay Styczynski, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1059 Issued in NH

Practice address

45 Lyme Rd Ste 201
Hanover, NH 03755-1260

Phone

(603) 643-2140

NPI assigned

Jul 10, 2021

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

Medicare fee-for-service enrollment

Enrolled in NH

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

Ohio State University - College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dufour Vision Care PLLCGroup PAC ID 7719498567, 5 clinicians

White River Family Eyecare, PCGroup PAC ID 7911910096, 3 clinicians

Practice addresses (Care Compare)

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.

• Dufour Vision Care PLLC

  • Optometrist
  • White River Junction, VT
  • NPI 1366257990

  NH

  Medicare reassignment Care Compare group NPD
• White River Family Eyecare, PC

  • Optometrist
  • White River Junction, VT
  • NPI 1104878206

  NH

  Medicare reassignment Care Compare group NPD
• Windsor Hospital Corporation

  • Internal Medicine Physician
  • Windsor, VT
  • NPI 1841287984
  NPD (past)

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

{
    "created_epoch": "1625875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1336711373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LYME RD",
            "address_2": "STE 201",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551260",
            "telephone_number": "603-643-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LYME RD STE 201",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551260",
            "telephone_number": "603-643-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "White River Junction",
            "state": "VT",
            "postal_code": "050090001",
            "country_code": "US",
            "telephone_number": "802-295-9363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STYCZYNSKI",
        "first_name": "MITCHELL",
        "middle_name": "JAY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-10",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133942",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Ruth Stanger, M.D.
• Donna Rachel Steinberg, PH.D.
• Mary Elizabeth Stevens
• Terry Stone-Porreca, LCMHC
• Erin Storm
• Katie Sullivan, CMHC
• Michael Sun
• Telecrossroads Inc
• Terrace Communities Hanover, LLC
• Town of Hanover

• Optometrist in Hanover, NH
• Providers in Hanover, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.