Individual provider Active NPI

William A. Macilwaine, M.D.

  • Ophthalmology Physician
  • Charlottesville, VA
National Provider Identifier
1215934864
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101032037 Issued in VA
Practice address
110 S Pantops Dr
Charlottesville, VA 22911-8672
Phone
(434) 977-5160
Fax
(434) 977-5202
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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 0101032037 VA Primary

Addresses

Primary practice location

110 S Pantops Dr
Charlottesville, VA 22911-8672

Mailing address

110 S Pantops Dr
Charlottesville, VA 22911-8672
Phone (434) 977-5160

Other identifiers 2

IdentifierTypeStateIssuer
0756400001OtherVADMERC
010811OtherVAANTHEM BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100520000753 VA Practitioner - Ophthalmology 7315845187 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101032037VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlottesville Eye Associates Ophthalmology CurrentSince Jun 30, 1981 Accepting new patients
Charlottesville Eye Associates LTD Ophthalmology CurrentSince Jun 30, 1981 Accepting new patients

Locations

110 S Pantops Dr
Charlottesvle, VA 22911
Phone (434) 977-5160

Organizations & group practices 2

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1215934864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PANTOPS DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118672",
            "telephone_number": "434-977-5160",
            "fax_number": "434-977-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PANTOPS DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118672",
            "telephone_number": "434-977-5160",
            "fax_number": "434-977-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACILWAINE",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101032037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0756400001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "010811",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.