Individual provider Active NPI

Mark A. Mlsna, O.D.

  • Optometrist
  • Menomonee Falls, WI
National Provider Identifier
1386743425
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TPA 2057-035 Issued in WI
Practice address
N89W16785 Appleton Ave
Menomonee Falls, WI 53051-2071
Phone
(262) 253-4000
Fax
(262) 253-4100
NPI assigned
Sep 22, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TPA 2057-035 WI Primary

Addresses

Primary practice location

N89W16785 Appleton Ave
Menomonee Falls, WI 53051-2071

Mailing address

N89W16785 Appleton Ave
Menomonee Falls, WI 53051-2071
Phone (262) 253-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050813000100 WI Practitioner - Optometry 4082644760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Eye Care of Wisconsin SCGroup PAC ID 7214268903, 4 clinicians

Practice addresses (Care Compare)

10425 W N Ave
Suite 140
Wauwatosa, WI 53226-2400
Phone (414) 877-6414

Merit-based Incentive Payment System (MIPS)

Final score
96.51 of 100Reported as group
Quality
97.5
Improvement activities
40
Cost
91.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPA 2057-035WIMDOptometrist
2057WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Eye Care of Wisconsin SC CurrentSince Nov 1, 2020 Accepting new patients

Locations

N89W16785 Appleton Ave
Menomonee Fls, WI 53051
Phone (262) 253-4000

N89W16785 Appleton Ave
Ste 3
Menomonee Fls, WI 53051

10425 W North Ave
Ste 140
Wauwatosa, WI 53226
Phone (414) 877-6414

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386743425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N89W16785 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512071",
            "telephone_number": "262-253-4000",
            "fax_number": "262-253-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N89W16785 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512071",
            "telephone_number": "262-253-4000",
            "fax_number": "262-253-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLSNA",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "TPA 2057-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.