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

Last updated

Jun 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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, PLLCGroup PAC ID 1153614292, 2 clinicians

Soave Eye Care PLLCGroup PAC ID 6103239306, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Soave Eye Care PLLC

  • Optometrist
  • Traverse City, MI
  • NPI 1689274516
  Medicare reassignment Care Compare group NPD
• Specialized Eye Care and Eye Wear Services, PLLC

  • Optometrist
  • Traverse City, MI
  • NPI 1225489909
  Medicare reassignment Care Compare group NPD
• Gaylord Eye Care Center Inc

  • Optometrist
  • Gaylord, MI
  • NPI 1306827837
  Medicare reassignment NPD

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

{
    "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

• Optometrist in Gaylord, MI
• Providers in Gaylord, MI by specialty
• 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.