Ethan David Wohlgemuth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3249 Issued in OK

Practice address

1001 N Grand Ave
Tahlequah, OK 74464-7017

Phone

(918) 444-4031

NPI assigned

Jul 20, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

85.4 of 100Reported as group

Quality

72.78

Promoting interoperability

98

Improvement activities

40

Cost

76.77

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1104506419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-444-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-444-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLGEMUTH",
        "first_name": "ETHAN",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tera Beth Windham, RD LD
• Charles Joseph Wine, M.D.
• Carter Reese Wisdom
• John Witosky, M.S.
• Chris Wofford
• Greggory Jon Woitte, MD
• Angel Lea Wolfe
• Patricia Womack, M.S. LPC
• Woodall School
• Victoria Cheyenne Woods-Reinicke, DO

• Optometrist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.