Wilson Omesiete, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

104251 Issued in GA

Practice address

1220 Langford Dr Ste 103
Watkinsville, GA 30677-7221

Phone

(706) 353-8220

Fax

(404) 816-7929

NPI assigned

Apr 6, 2018

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 GA

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 1

Specialty

Dermatology

Education

Medical College of Georgia School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Affiliates LLCGroup PAC ID 5799763975, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wilson.omesiete.1@20955.direct.athenahealth.com

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.

• Dermatology Affiliates, LLC

  • Specialist
  • Atlanta, GA
  • NPI 1730244872
  Medicare reassignment Care Compare group NPD
• Pinnacle Dermatology, S.C.

  • Non-Pharmacy Dispensing Site
  • Watkinsville, GA
  • NPI 1194652925
  NPD (past)

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1609373695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LANGFORD DR STE 103",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777221",
            "telephone_number": "706-353-8220",
            "fax_number": "706-353-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LANGFORD DR STE 103",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777221",
            "telephone_number": "706-353-8220",
            "fax_number": "404-816-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMESIETE",
        "first_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "104251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oconee Surgery Center
• Oconee Vision Group, LLC
• Oconee Wholesome Medical LLC
• Oconne County Commissioner of Roads & Revenues
• Kathleen M. Ollendick, PT
• Optical Experts, LLC
• Origins Spine and Joint Physicians, LLC
• Timothy Jay Orlowski, MD
• Krystal Nicole Osborne, FNP-C
• George Glennwood Osgoodby Jr., DC

• Dermatology Physician in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.