Individual provider Active NPI

Duane L Wires, O.D.

  • Optometrist
  • Ada, OH
National Provider Identifier
1427040633
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3756 Issued in OH
Practice address
107 S Main St
Ada, OH 45810-1240
Phone
(419) 634-2921
Fax
(419) 634-9858
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3756 OH Primary

Addresses

Primary practice location

107 S Main St
Ada, OH 45810-1240

Mailing address

107 S Main St
Ada, OH 45810-1240
Phone (419) 634-2921

Other identifiers 1

IdentifierTypeStateIssuer
055775MedicaidOH

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
I20031117000082 OH Practitioner - Optometry 0345154100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3756OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes on Main Optometry LLC Optometrist CurrentSince Sep 1, 1990 Accepting new patients
Eyes on Main Optometry LLC Optometrist CurrentSince Jan 9, 1990 Accepting new patients

Locations

107 S Main St
Ada, OH 45810
Phone (419) 634-2921

334 S Main St
Findlay, OH 45840
Phone (419) 422-2015

Interoperability endpoints

  • Direct secure messaging: dwires@eyesonmainvisioncenter.emadirect.md

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, 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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1427040633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458101240",
            "telephone_number": "419-634-2921",
            "fax_number": "419-634-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458101240",
            "telephone_number": "419-634-2921",
            "fax_number": "419-634-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRES",
        "first_name": "DUANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055775",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OH

Sources for this page

Verify at the official NPI Registry.