Individual provider Active NPI

Riley Jane Wilson, OD

  • Optometrist
  • Seymour, IN
National Provider Identifier
1205510286
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004406A Issued in IN
Practice address
707 W Tipton St
Seymour, IN 47274-2157
Phone
(812) 524-3937
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004406A IN Primary

Addresses

Primary practice location

707 W Tipton St
Seymour, IN 47274-2157

Mailing address

837 S Poplar St
Brownstown, IN 47220-1900
Phone (812) 569-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20230629002649 IN Practitioner - Optometry 0749649366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conner Smith Eye Center PCGroup PAC ID 8022162478, 3 clinicians

Practice addresses (Care Compare)

707 W Tipton
Seymour, IN 47274-2157

707 W Tipton St
Seymour, IN 47274-2157
Phone (812) 524-3937

Merit-based Incentive Payment System (MIPS)

Final score
92.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1205510286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 S POPLAR ST",
            "city": "BROWNSTOWN",
            "state": "IN",
            "postal_code": "472201900",
            "telephone_number": "812-569-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742157",
            "telephone_number": "812-524-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RILEY",
        "middle_name": "JANE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004406A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.