Individual provider Active NPI

Erin Marie Wu, O.D.

  • Optometrist
  • Pontiac, MI
National Provider Identifier
1003128877
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005011 Issued in MI
Practice address
22 N Telegraph Rd
Pontiac, MI 48341-1166
Phone
(248) 332-2895
Fax
(248) 332-4896
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010389 IL
Optometrist 152W00000X 002538 IA
Optometrist 152W00000X 4901005011 MI Primary

Addresses

Primary practice location

22 N Telegraph Rd
Pontiac, MI 48341-1166

Mailing address

PO Box 208177
Dallas, TX 75320-8177
Phone (636) 200-4393

Other practice location 1

1451 Coral Ridge Ave
Suite 104
Coralville, IA 52241-2801
Phone (319) 354-5185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002538IAMDOptometrist
046010389ILMDOptometrist
4901005011MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Site Vision Center, PC Optometrist PastSince Jun 1, 2005 Accepting new patients
Site Vision Center Optometrist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1003128877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208177",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208177",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N TELEGRAPH RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411166",
            "telephone_number": "248-332-2895",
            "fax_number": "248-332-4896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 Coral Ridge Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412801",
            "country_code": "US",
            "telephone_number": "319-354-5185",
            "fax_number": "319-354-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010389",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002538",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.