Active NPI
Peter Wyzinski, MD
- Ophthalmology Physician
- Eugene, OR
National Provider Identifier
1114947751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD14320
- Practice address
- 1125 Darlene LN
Suite 100
Eugene, OR 97401-1601 - Phone
- (541) 343-5000
- Fax
- (541) 344-9478
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD14320 | OR | Primary |
Addresses
Primary practice location
1125 Darlene LN
Suite 100
Eugene, OR 97401-1601
Mailing address
PO Box 10888
Eugene, OR 97440-2888
Phone (541) 343-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143115 | Medicaid | OR | |
| 012381-0004 | Other | OR | PACIFICARE/SECURE HORIZON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD14320 | OR | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1114947751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10888",
"city": "EUGENE",
"state": "OR",
"postal_code": "974402888",
"telephone_number": "541-343-5000",
"fax_number": "541-344-9478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 DARLENE LN",
"address_2": "SUITE 100",
"city": "EUGENE",
"state": "OR",
"postal_code": "974011601",
"telephone_number": "541-343-5000",
"fax_number": "541-344-9478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYZINSKI",
"first_name": "PETER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD14320",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143115",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE/SECURE HORIZON",
"identifier": "012381-0004",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.