Active NPI
Mark D Mylin, CST/CFA
- Surgical Assistant
- Janesville, WI
National Provider Identifier
1679734487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 91004
- Practice address
- 1000 Mineral Point Ave
Janesville, WI 53548-2940 - Phone
- (608) 756-6000
- NPI assigned
- Jun 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 91004 | WI | Primary |
Addresses
Primary practice location
1000 Mineral Point Ave
Janesville, WI 53548-2940
Mailing address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91004 | Other | WI | STATE CERTIFICATION NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91004 | WI | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1679734487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MINERAL POINT AVE",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535482940",
"telephone_number": "608-756-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MINERAL POINT AVE",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535482940",
"telephone_number": "608-756-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYLIN",
"first_name": "MARK",
"middle_name": "D",
"credential": "CST/CFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-24",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "WI",
"license": "91004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CERTIFICATION NUMBER",
"identifier": "91004",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.