Individual provider Active NPI

Mark B Kislinger, M.D.

  • Ophthalmology Physician
  • Glendora, CA
National Provider Identifier
1477733772
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A40962 Issued in CA
Practice address
210 S Grand Ave
Ste 106
Glendora, CA 91741
Phone
(626) 335-0535
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A40962 CA Primary

Addresses

Primary practice location

210 S Grand Ave
Ste 106
Glendora, CA 91741

Mailing address

210 S Grand Ave
Ste 106
Glendora, CA 91741-4205
Phone (626) 335-0535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000291 CA Practitioner - Ophthalmology 5799846523

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A40962CAMDOphthalmology Physician
40962CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyenez Integrated Managed Eye Care Network, a Medical Group, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Golden State Eye Medical Group Inc Ophthalmology Past Accepting new patients

Locations

210 S Grand Ave
Ste 106
Glendora, CA 91741
Phone (626) 335-0535

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mark.kislinger.p44@direct.healthcarepartners.nextgenshare.com

Organizations & group practices 2

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": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1477733772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "STE 106",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-335-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "STE 106",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91741",
            "telephone_number": "626-335-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLINGER",
        "first_name": "MARK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A40962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.