Jon R Wilzonski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2019021299 Issued in MO

Practice address

1235 Water Tower PL
Arnold, MO 63010-2142

Phone

(636) 296-8612

Fax

(636) 296-8055

NPI assigned

Jul 3, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jon R Wilson Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diane G. Wilson, OD and Associates, PCGroup PAC ID 6608949425, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Diane G. Wilson, OD & Associates, PC

  • Optometrist
  • Arnold, MO
  • NPI 1770619637
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1063074540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 WATER TOWER PL",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102142",
            "telephone_number": "636-296-8612",
            "fax_number": "636-296-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 WATER TOWER PL",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102142",
            "telephone_number": "636-296-8612",
            "fax_number": "636-296-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILZONSKI",
        "first_name": "JON",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019021299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JON",
            "last_name": "WILSON",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Curtis Willingham, PHARMD
• Alexandra B Willis, LPC
• Christine Wilson
• Diane G Wilson, O.D.
• Kinsey Marie Wilson, DPT
• Zachary T Winchester, DPT
• Abigail Rose Wing, OTD, OTR/L
• Amber Wingbermuehle
• Maureen Wiszkon, MA, LPC
• Wojtyna DDS II LLC

• Optometrist in Arnold, MO
• Providers in Arnold, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.