John J Mytych, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

3271756 Issued in ID

Practice address

2120 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639

Phone

(208) 625-6944

Fax

(208) 625-6945

NPI assigned

Sep 25, 2006

Last updated

Jun 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

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

Podiatry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Merit-based Incentive Payment System (MIPS)

Final score

85.38 of 100Reported as group

Quality

67.22

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmytych840040@direct.multicare.org

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.

• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur d'Alene, ID
  • NPI 1174661151
  Medicare reassignment Care Compare group NPD
• Kootenai Health, Inc.

  dba Kootenai Health Pharmacy

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD
• Kootenai Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Coeur d'Alene, ID
  • NPI 1609925023
  NPD
• Utah Podiatry Group PC

  dba Advanced Foot And Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • South Ogden, UT
  • NPI 1225796790
  NPD
• Kootenai Health, Inc.

  dba Kootenai Medical Center Group

  • Emergency Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1235288655
  NPD (past)
• Elgin Foot & Ankle Center, S.C.

  • Foot & Ankle Surgery Podiatrist
  • Elgin, IL
  • NPI 1639270663
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1457452476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106236",
            "telephone_number": "801-505-0821",
            "fax_number": "801-505-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-6944",
            "fax_number": "208-625-6945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2159 S 700 E Ste 150",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841062279",
            "country_code": "US",
            "telephone_number": "801-466-1333",
            "fax_number": "801-466-6601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "962 Chambers St",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844035087",
            "country_code": "US",
            "telephone_number": "801-373-2499",
            "fax_number": "801-373-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYTYCH",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "10140276-0501",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "3271756",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "10140276-0501",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U00011270",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "Q00214425",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.