Individual provider Active NPI

Deborah Yvonne Wilson, M.D.

  • Ophthalmology Physician
  • Riverdale, MD
National Provider Identifier
1174578744
Registry record updated Oct 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0050068 Issued in MD
Practice address
6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339
Phone
(301) 699-1882
Fax
(301) 209-9456
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0050068 MD Primary

Addresses

Primary practice location

6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339

Mailing address

6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339
Phone (301) 699-1882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000456 DC Practitioner - OphthalmologyPractitioner - Internal Medicine 8729022652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Internal Medicine
Education
Duke University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 339-0001

6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339
Phone (301) 699-1882

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as individual
Quality
69.38
Improvement activities
40
Cost
65.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0050068MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye One Surgical Assoc Ophthalmology CurrentSince May 1, 2004 Accepting new patients

Locations

3800 Reservoir Rd NW
Bldg Phc
Washington, DC 20007
Phone (202) 339-0001

3800 Reservoir Rd NW
Ph
Washington, DC 20007
Phone (202) 339-0001

6510 Kenilworth Ave
Ste 1300
Riverdale, MD 20737
Phone (301) 699-1166

Interoperability endpoints

  • Direct secure messaging: deborah.wilson-umanzor.1@926.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/926/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193529600000",
    "number": "1174578744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVE",
            "address_2": "SUITE 1300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371339",
            "telephone_number": "301-699-1882",
            "fax_number": "301-209-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVE",
            "address_2": "SUITE 1300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371339",
            "telephone_number": "301-699-1882",
            "fax_number": "301-209-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEBORAH",
        "middle_name": "YVONNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0050068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

Verify at the official NPI Registry.