Johanna Mauk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004978 Issued in MI

Practice address

829 W Main St Ste E
Gaylord, MI 49735-1998

Phone

(989) 732-6261

NPI assigned

Jun 27, 2016

Sex

Female

Sole proprietor

No

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.

• Soave Eye Care PLLC

  • Optometrist
  • Traverse City, MI
  • NPI 1689274516

  MI, Optometrist

  Medicare reassignment Care Compare group NPD
• Specialized Eye Care and Eye Wear Services, PLLC

  • Optometrist
  • Traverse City, MI
  • NPI 1225489909

  MI, Optometrist

  Medicare reassignment Care Compare group NPD
• Gaylord Eye Care Center Inc

  • Optometrist
  • Gaylord, MI
  • NPI 1306827837

  MI, Optometrist

  Medicare reassignment NPD

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialized Eye Care and Eye Wear Services, PLLC 2 clinicians

Soave Eye Care PLLC 2 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 27, 2016.

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1720439102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 W MAIN ST STE E",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351998",
            "telephone_number": "989-732-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 W MAIN ST STE E",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351998",
            "telephone_number": "989-732-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUK",
        "first_name": "JOHANNA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel L Martin, RPH
• Brandi S Masar, RN
• Amber Maser
• Megan Marie Matelski
• Irineo C Matias, M.D.
• Julia Mauldin
• Matthew A Mazur, D.O.
• Elizabeth Jean Mazzella, AGNP
• Michelle McCarry, RN
• Clorissa M McEachern, CPNP-PC

• All providers in Gaylord, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.