Samuel W. Wilkinson, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A208005 Issued in CA

Practice address

65 N Mario Capecchi
Salt Lake City, UT 84132-0002

Phone

(801) 581-2121

NPI assigned

Mar 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Ophthalmology

Education

University of Utah School of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1083354179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MARIO CAPECCHI",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MARIO CAPECCHI",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Century Park E Ste 911",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900672012",
            "country_code": "US",
            "telephone_number": "310-229-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "SAMUEL",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "13534814-1205",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A208005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery Wilkinson
• Joey Michael Wilkinson, PHARM.D.
• Kriselle Wilkinson
• Mark Ford Wilkinson, D.O.
• N. Nicole Wilkinson, P.T.
• Alissa Willard
• Allison Kathryn Willard, MD
• Tammy Lynn Willard
• Teresa Willard, LCSW
• McKae Willardsen

• Ophthalmology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.