Nikhil Sudhakar Wagle, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-100181 Issued in IL

Practice address

4731 45TH Street CT
Rock Island, IL 61201-7102

Phone

(309) 793-2020

Fax

(309) 793-2602

NPI assigned

Dec 28, 2005

Last updated

Mar 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Wisconsin School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Surgeons Associates PCGroup PAC ID 4183521206, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.56 of 100Reported as group

Quality

97.61

Promoting interoperability

98

Improvement activities

40

Cost

32.58

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nikhil.wagle.p2@direct.urologyqc.nextgenshare.com
• Direct secure messaging: nikhil.waglemd.p1@direct.esaeyecare.nextgenshare.com

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.

• Eye Surgeons Associates PC

  • Ophthalmology Physician
  • Bettendorf, IA
  • NPI 1386607562

  IL

  Medicare reassignment Care Compare group NPD
• Eye Surgeons Associates PC

  • Eyewear Supplier
  • Rock Island, IL
  • NPI 1316030034

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1003893454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 TANGLEFOOT LN",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221650",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 45TH STREET CT",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017102",
            "telephone_number": "309-793-2020",
            "fax_number": "309-793-2602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Tanglefoot Ln",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527221650",
            "country_code": "US",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGLE",
        "first_name": "NIKHIL",
        "middle_name": "SUDHAKAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-100181",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "33115",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "IA",
            "license": "33115",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "IL",
            "license": "036-100181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL GROUP MEDICARE",
            "identifier": "790730",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA GROUP MEDICAID",
            "identifier": "0060350",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA GROUP MEDICARE",
            "identifier": "26568",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Vosberg
• Sandra J Voss, LSW, LMSW
• Jack G Vukov, MD
• Danielle Jillian Waddle, LMSW
• Archana G Wagle, MD
• Haley Wagler
• Kylie Waldbusser
• Walgreen Co (Walgreens #03991)
• Walgreen Co (Walgreens #04332)
• Sarah Walker, RN, SANE-A

• Ophthalmology Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.