Mark William Wellman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2182 Issued in AZ

Practice address

18431 N 91St Ave Ste 1
Peoria, AZ 85382-0817

Phone

(623) 393-8324

NPI assigned

Jun 27, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• John H McDougall OD Arizona PC

  dba 20/20 Image Eye Centers

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  Medicare reassignment Care Compare group NPD
• John R Tanner OD PLLC

  • Optometrist
  • Peoria, AZ
  • NPI 1437582152
  Medicare reassignment NPD
• Gary L Morgan OD PC

  dba Eye Tech Eye Associates

  • Optometrist
  • Peoria, AZ
  • NPI 1073502167
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487175741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE STE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-393-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE STE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-393-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maile Marie Weigele-Wolfe, RN
• Weight Loss MD (MD Weight Loss)
• Olivia Weintraub-Farr, MS, LAC
• Zachary Weisenberger, PT, DPT
• Wayne A Weissinger, NPC
• Wellness for Life Family Practice
• Wellness Today Medical Clinic, Inc.
• Janeen Lealice Wells, LPC
• Kiersten Wells, LCSW
• Elizabeth Ann Wennerstrom, PA

• Optometrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.