Individual provider Active NPI

John Anthony Wiener, OD

  • Optometrist
  • Milford, OH
National Provider Identifier
1417024621
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.004061 Issued in OH
Practice address
1090 State Route 28
Milford, OH 45150-4936
Phone
(513) 575-9464
Fax
(513) 575-9466
NPI assigned
Nov 30, 2006
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.004061 OH Primary

Addresses

Primary practice location

1090 State Route 28
Milford, OH 45150-4936

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 2

IdentifierTypeStateIssuer
92734892OtherOHMEDICARE, UNSPECIFIED
WI0734892OtherOHMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20071017000461 OH Practitioner - Optometry 8820184252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4061OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 26, 2021 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 26, 2021 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Dr. Tonya D. Lindsell and Associates, LLC Optometrist PastSince Jun 17, 2014 Accepting new patients

Locations

5303 Glenway Ave
Cincinnati, OH 45238
Phone (513) 921-8040

1090 State Route 28
Ste A
Milford, OH 45150
Phone (513) 575-9464

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1417024621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 STATE ROUTE 28",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451504936",
            "telephone_number": "513-575-9464",
            "fax_number": "513-575-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.004061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, UNSPECIFIED",
            "identifier": "92734892",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "WI0734892",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

Verify at the official NPI Registry.