Nathan Michael Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2550 Issued in CO

Practice address

10669 Melody Dr
Northglenn, CO 80234-4113

Phone

(303) 452-9312

Fax

(303) 452-3515

NPI assigned

Sep 26, 2006

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 ID

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

University of California - School of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson Polito PLLCGroup PAC ID 9931386174, 4 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 and National Provider Directory roles.

• Wilson Polito PLLC

  • Optometrist
  • Lewiston, ID
  • NPI 1710276324
  Medicare reassignment Care Compare group NPD Authorized official
• Wilson Polito PLLC

  • Optometrist
  • Moscow, ID
  • NPI 1285170696
  NPD Authorized official
• Flatirons Optometric Group, PC

  • Optometrist
  • Louisville, CO
  • NPI 1598854747
  NPD (past)
• Stephen Brockbank O.D. L.L.C.

  • Optometrist
  • Lewiston, ID
  • NPI 1750511184
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164523643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10669 MELODY DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344113",
            "telephone_number": "303-452-9312",
            "fax_number": "303-452-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10669 MELODY DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344113",
            "telephone_number": "303-452-9312",
            "fax_number": "303-452-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharla D Williams, B.S.
• Tracy Williams II
• Katherine Aurora Willie, MD
• Michele C Willingham, MA, LPC, LAC
• Cassidy Danielle Wilson
• Hannah Marie Winner, DACM, L.AC, DIPL. OM
• Erica Marie Winslow, OTR
• Anastacia Montana Winter, LPCC.0017020
• Woods N Waters Wellness PLLC
• Woods N Waters Wellness PLLC

• Optometrist in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.