Brent Ronald Mittelstaedt, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4519 Issued in TN

Practice address

3400 Lebanon Rd
Murfreesboro, TN 37129-1392

Phone

(615) 867-6000

NPI assigned

Feb 5, 2008

Last updated

Sep 23, 2021By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Ophthalmology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Craig Berger MD PLGroup PAC ID 0547368995, 5 clinicians

Vision One IncGroup PAC ID 9830197623, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Craig Berger MD PL

  dba Bay Area Eye Institute

  • Ophthalmology Physician
  • Tampa, FL
  • NPI 1235282468
  Medicare reassignment Care Compare group NPD
• Vision One Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1457308322
  Medicare reassignment Care Compare group NPD
• Central Florida Cataract and Laser Surgery Center, Inc.

  • Ophthalmologic Surgery Clinic/Center
  • Deland, FL
  • NPI 1508063884

  Ophthalmology

  Medicare reassignment NPD
• Crystal River Eye Center,LLC

  dba Envision Eye Specialists

  • Ophthalmology Physician
  • Crystal River, FL
  • NPI 1619119948
  Medicare reassignment NPD
• Lebowitz Medical Group PA

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1568501344
  NPD (past)
• Vision One Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1952314346
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1679751358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 SAINT JOHNS DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371295834",
            "telephone_number": "732-801-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LEBANON RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291392",
            "telephone_number": "615-867-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTELSTAEDT",
        "first_name": "BRENT",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "OS014462",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS13484",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "278557",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "4519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Mitchell, PT
• Michelle Mitchell
• Rebecca E Mitchell
• Sydnee Mitchell
• Tristan Kane Mitchell
• Mix It Up Beverage Co LLC
• Daniel John Mleziva II, RN
• MMR Senior Alliance Corporation (Right at Home of Middle Tennessee)
• Mobile Extremity MRI LLC
• Derrick Lamount Mobley

• Ophthalmology Physician in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.