NPIMap

Individual provider Active NPI

Kyle Piwonka, D.O.

  • Retina Specialist (Ophthalmology) Physician
  • Durango, CO
National Provider Identifier
1881823581
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
DR.0055096 Issued in CO
Practice address
575 Rivergate LN Unit 212
Durango, CO 81301-7488
Phone
(970) 259-2202
Fax
(970) 259-2837
NPI assigned
Jul 2, 2009
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X DR.0055096 CO
Retina Specialist (Ophthalmology) Physician 207WX0107X DR.0055096 CO Primary

Addresses

Primary practice location

575 Rivergate LN Unit 212
Durango, CO 81301-7488

Mailing address

575 Rivergate LN Unit 212
Durango, CO 81301-7488
Phone (970) 259-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624002019 CO Practitioner - Ophthalmology 1456595586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Four Corners Eye Clinic, PCGroup PAC ID 1658263173, 6 clinicians

Practice addresses (Care Compare)

575 Rivergate LN
Unit 212
Durango, CO 81301-7488
Phone (970) 259-2202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.36 of 100Reported as group
Quality
91.86
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Eye Institute PLLC Ophthalmology Current Accepting new patients
Four Corners Eye Clinic, PC CurrentSince Feb 1, 2024 Accepting new patients
Mark R Comaratta MD PC Ophthalmology CurrentSince Jan 1, 2023 Accepting new patients
Four Corners Eye Clinic, PC CurrentSince Feb 1, 2024 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Ophthalmology Past Accepting new patients
Southwestern Eye Center LTD Past Accepting new patients

Locations

575 Rivergate Ln
Unit 212
Durango, CO 81301
Phone (970) 259-2202

1940 W Dickerson St
Ste 103
Bozeman, MT 59718
Phone (406) 224-2370

Interoperability endpoints

  • Direct secure messaging: kpiwonka@triadeye.intellechartdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1881823581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LN UNIT 212",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017488",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LN UNIT 212",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017488",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIWONKA",
        "first_name": "KYLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0055096",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CO",
            "license": "DR.0055096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.