Wildwood Eye Care LLC
A Medicare group practice based in Marietta, GA: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 5890839138), with 5 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 5890839138
- Provider type
- Part B Supplier - Clinic/Group Practice
- Enrolled in
- GA
- Enrollments
- 1
- Group size
- 5 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 2
Enrollment records 1
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20100224000431 | GA | Part B Supplier - Clinic/Group Practice | 1396073862 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Wildwood Eye Care LLC
- Optometrist
- Marietta, GA
- NPI 1396073862
-
Wildwood Eye Care LLC
- Optometrist
- Dawsonville, GA
- NPI 1609768464
Practice locations
- Dawsonville, GA1
- Marietta, GA1
Clinicians 5
Clinicians who reassign their Medicare benefits to this group (5) or whom Care Compare lists as members (5).
-
Patrick Dicus, OD
- Optometrist
- Alpharetta, GA
- NPI 1093494379
-
Nicole L Mardak, O.D.
- Optometrist
- Marietta, GA
- NPI 1033551767
-
Stuart R Tasman, OD
- Optometrist
- Marietta, GA
- NPI 1073548426
-
Karla Reece Thomason, O.D.
- Optometrist
- Dawsonville, GA
- NPI 1598107682
-
Heather Zutaut, O.D.
- Optometrist
- Marietta, GA
- NPI 1699709246
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.