Wayne G Wilde, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002777 Issued in MI

Practice address

7074 Highland Rd Ste a
Waterford, MI 48327-1500

Phone

(248) 698-2000

Fax

(248) 698-2655

NPI assigned

Feb 15, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clarity Advanced Eyecare, PLLC

  • Optometrist
  • Birmingham, MI
  • NPI 1639582919

  MI, Optometrist

  Medicare reassignment NPD
• Clarity Advanced Eyecare, PLLC

  • Optometrist
  • South Lyon, MI
  • NPI 1336286012
  NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1104890342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7074 HIGHLAND RD STE A",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271500",
            "telephone_number": "248-698-2000",
            "fax_number": "248-698-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7074 HIGHLAND RD STE A",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271500",
            "telephone_number": "248-698-2000",
            "fax_number": "248-698-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "WAYNE",
        "middle_name": "G",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "900F367410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William White
• Richard James Whitman III
• James Council Wickersham, LMSW, CAADC
• Andrew Wideman, D.C.
• Loretta Wiggins, LLPC
• Joyce Jonekait Wilkerson, LMSW
• William Scott Ward DDS
• Cheyenna Williams
• Daniel Williams, BA SOCIOLOGY, CHW
• Jordyn Ryah Williams, AT, ATC

• All providers in Waterford, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.