Individual provider Active NPI

Justin Richards Wilkin, M.D.

  • Ophthalmology Physician
  • Marietta, GA
National Provider Identifier
1184949687
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
071652 Issued in GA
Practice address
895 Canton Rd NE
Marietta, GA 30060-8934
Phone
(770) 427-8111
NPI assigned
Mar 29, 2010
Last updated
Jun 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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 071652 GA Primary

Addresses

Primary practice location

895 Canton Rd NE
Marietta, GA 30060-8934

Mailing address

3454 Chastain Glen LN NE
Marietta, GA 30066-8510
Phone (706) 664-7987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140926002044 GA Practitioner - Ophthalmology 9931345485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Georgia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

2990 Eagle Dr
Suite 110
Woodstock, GA 30189-5575
Phone (770) 427-8111

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

895 Canton Rd NE
BLDG 200
Marietta, GA 30060-8934
Phone (770) 427-8111

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery718

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071652GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic PA Ophthalmology Current Accepting new patients
Marietta Eye Clinic, PA Ophthalmology CurrentSince Aug 4, 2014 Accepting new patients
Marietta Eye Clinic, PA Ophthalmology Past Accepting new patients
Marietta Eye Clinic, PA Ophthalmology Past Accepting new patients
Marietta Eye Clinic, PA Ophthalmology PastSince Jan 29, 2023 Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1104
Acworth, GA 30101
Phone (678) 279-1141

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1184949687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 CHASTAIN GLEN LN NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300668510",
            "telephone_number": "706-664-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIN",
        "first_name": "JUSTIN",
        "middle_name": "RICHARDS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "071652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.