Individual provider Active NPI

Ross W Mlsna, O.D.

  • Optometrist
  • Yorkville, IL
National Provider Identifier
1457428542
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008133 Issued in IL
Practice address
120 E Countryside Pkwy
Yorkville, IL 60560-1877
Phone
(630) 553-6166
Fax
(630) 553-6178
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 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 046008133 IL Primary

Addresses

Primary practice location

120 E Countryside Pkwy
Yorkville, IL 60560-1877

Mailing address

120 E Countryside Pkwy
Yorkville, IL 60560-1877
Phone (630) 553-6166

Other identifiers 1

IdentifierTypeStateIssuer
046008133MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20091208000157 IL Practitioner - Optometry 3173662913 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brenart Eye Clinic, LLCGroup PAC ID 1456306851, 8 clinicians
Mlsna Family Eye Care SCGroup PAC ID 4981799657, 2 clinicians

Practice addresses (Care Compare)

120 E Countryside Pkwy
Yorkville, IL 60560-1877
Phone 63055361661002

719 Lincoln Ave
Rochelle, IL 61068-1867
Phone (815) 562-6175

Merit-based Incentive Payment System (MIPS)

Final score
40.05 of 100Reported as group
Quality
80.09
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brenart Eye Clinic, LLC Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Macqueen Eye Care Center LTD Optometrist CurrentSince Oct 1, 2001 Accepting new patients
Fagman Eye Surgery Associates PastSince Oct 1, 2001 Accepting new patients

Locations

7117 W Archer Ave
Chicago, IL 60638
Phone (773) 586-8444

1 E County Line Rd
Sandwich, IL 60548
Phone (815) 786-2722

120 E Countryside Pkwy
Yorkville, IL 60560
Phone (630) 553-6166

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1457428542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E COUNTRYSIDE PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601877",
            "telephone_number": "630-553-6166",
            "fax_number": "630-553-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E COUNTRYSIDE PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601877",
            "telephone_number": "630-553-6166",
            "fax_number": "630-553-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLSNA",
        "first_name": "ROSS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008133",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

Verify at the official NPI Registry.