Individual provider Active NPI

Lee Angelo Wiley

  • Ophthalmology Physician
  • Pineville, NC
National Provider Identifier
1518351493
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2020-00983 Issued in NC
Practice address
10405 Centrum Pkwy
Pineville, NC 28134-8825
Phone
(704) 295-3650
Fax
(704) 295-3660
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 2020-00983 NC Primary

Addresses

Primary practice location

10405 Centrum Pkwy
Pineville, NC 28134-8825

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other practice location 1

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other practice location 2

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone (704) 295-3475

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwileymd34494@direct.ceenta.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200708003238 NC Practitioner - Ophthalmology 0143522953 Reassigns benefits to 1 organization
I20200918001515 SC Practitioner - Ophthalmology 0143522953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
West Virginia University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10405 Centrum Pkwy
Pineville, NC 28134-8825
Phone (704) 295-3650

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone (704) 295-3475

1632 E Roosevelt Blvd
Monroe, NC 28112-4017
Phone (704) 295-3725

601 Sutton Rd S
Suite 201
Fort Mill, SC 29715-8439
Phone (803) 547-3800

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery326

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-00983NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, PA Ophthalmology CurrentSince Aug 25, 2020 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA Ophthalmology CurrentSince Apr 13, 2025 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Ophthalmology CurrentSince Aug 25, 2020 Accepting new patients

Locations

10512 Park Rd
Ste 200
Charlotte, NC 28210
Phone (704) 295-3650

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

13532 Steelecroft Pkwy
Charlotte, NC 28278
Phone (704) 295-3475

10405 Centrum Pkwy
Pineville, NC 28134
Phone (704) 295-3650

601 Sutton Rd S
Ste 201
Fort Mill, SC 29715
Phone (803) 328-1864

200 Herlong Ave S
Ste A
Rock Hill, SC 29732
Phone (803) 324-1028

Interoperability endpoints

  • Direct secure messaging: lwiley499465@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1518351493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10405 CENTRUM PKWY",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281348825",
            "telephone_number": "704-295-3650",
            "fax_number": "704-295-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6035 Fairview Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282103256",
            "country_code": "US",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13532 Steelecroft Pkwy",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787545",
            "country_code": "US",
            "telephone_number": "704-295-3475",
            "fax_number": "704-295-3476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "LEE",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2020-00983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwileymd34494@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "10512 Park Rd Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pineville, NC

Sources for this page

Verify at the official NPI Registry.