Tyler Wadzinski

Primary specialty

OptometristTaxonomy code 152W00000X

License

3456 Issued in TN

Practice address

1760 W Morris Blvd
Morristown, TN 37813-2834

Phone

(235) 581-2020

NPI assigned

Aug 8, 2018

Last updated

Jun 3, 2021By the provider in NPPES

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

Enrolled in TN

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

Southern College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Associates of Morristown, Inc.Group PAC ID 3173549094, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eyecare Associates of Morristown, Inc.

  • Optometrist
  • Morristown, TN
  • NPI 1659452639
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1124507496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132834",
            "telephone_number": "235-581-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADZINSKI",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W. Robert Gronewald, M.D., P.C.
• Jennifer Waddle
• Sherry Nicole Wade
• Edie Wadsworth, MD
• Steven M Wadsworth, DPM
• Lisha Inez Wagner, RN
• Jennifer Waitt, MSW
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5467)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0685)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6370)

• Optometrist in Morristown, TN
• Providers in Morristown, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.