Individual provider Active NPI

Ryan Curtis Wilkerson, OD

  • Optometrist
  • California, MO
National Provider Identifier
1447601679
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2016020870 Issued in MO
Practice address
202 E North St
California, MO 65018-1583
Phone
(573) 792-2222
Fax
(573) 796-5184
NPI assigned
Jun 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2016020870 MO Primary

Addresses

Primary practice location

202 E North St
California, MO 65018-1583

Mailing address

500 N Keene St
Suite 103
Columbia, MO 65201-8104
Phone (573) 874-2030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160810002626 MO Practitioner - Optometry 9830483015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Eye Consultants Optometry 14 clinicians

Practice addresses (Care Compare)

500 N Keene St
Suite 103
Columbia, MO 65201-8104
Phone (573) 874-2030

Merit-based Incentive Payment System (MIPS)

Final score
91.71 of 100Reported as group
Quality
95.95
Improvement activities
40
Cost
77.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Consultants Optometry Optometrist CurrentSince Aug 1, 2016 Accepting new patients
Columbia Eyewear PastSince Aug 1, 2016 Accepting new patients

Locations

202 E North St
California, MO 65018
Phone (573) 796-2222

500 N Keene St
Ste 103
Columbia, MO 65201
Phone (573) 874-2030

1705 Prospect Dr
Macon, MO 63552
Phone (660) 385-5724

1633 S Morley St
Moberly, MO 65270
Phone (573) 874-2030

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1447601679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-874-2030",
            "fax_number": "573-449-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E NORTH ST",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "650181583",
            "telephone_number": "573-792-2222",
            "fax_number": "573-796-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "RYAN",
        "middle_name": "CURTIS",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2016020870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MO

Sources for this page

Verify at the official NPI Registry.