Mark Edward Kosciuszko, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002884 Issued in MI

Practice address

50 W Carleton Rd
Hillsdale, MI 49242-1202

Phone

(517) 439-2020

Fax

(517) 437-5577

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Sky Vision Eye Care PCGroup PAC ID 8820065618, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.03 of 100Reported as group

Quality

85.46

Promoting interoperability

100

Improvement activities

40

Cost

31.32

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.kosciuszko.p1@direct.grophthalmology.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Blue Sky Vision Eye Care, P.C

  dba Grand Rapids Ophthalmology

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1801977202

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gossage Eye Institute, PLC

  • Ophthalmology Physician
  • Hillsdale, MI
  • NPI 1285854000
  Medicare reassignment NPD
• Blue Sky Vision Eye Care, PC

  dba Tukel Eye Center

  • Ophthalmology Physician
  • Dearborn, MI
  • NPI 1316675598
  NPD
• Cherry Street Services, Inc.

  dba Ottawa Hills High School Health Center

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1124187471
  NPD (past)
• Great Lakes Plastic Reconstructive & Hand Surgery P C

  dba Great Lakes Plastic and Hand Surgery

  • Plastic Surgery Physician
  • Portage, MI
  • NPI 1336335785
  NPD (past)
• Mid Michigan Eye Care Center, PC

  dba Specialty Eye Institute

  • Ophthalmology Physician
  • Jackson, MI
  • NPI 1649275041

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1841289774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W CARLETON RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421202",
            "telephone_number": "517-439-2020",
            "fax_number": "517-437-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W CARLETON RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421202",
            "telephone_number": "517-439-2020",
            "fax_number": "517-437-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSCIUSZKO",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "37252313",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4696989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBA   PHP",
            "identifier": "2230027",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4414910001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "900A210280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Klein, FNP
• Knapp Chiropractic Center PLLC
• David M. Knapp, D.C.
• Jeff Duane Knapp, D.C.
• Kurt Daniel Knapp, D.C.
• Jeffrey M. Kovacic, D.C.
• Krishan PC
• Kroger Co of Michigan (Kroger Pharmacy)
• Kyle T Kronemeyer, RPH
• Cody J Kryfka

• Optometrist in Hillsdale, MI
• Providers in Hillsdale, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.