Roy A Wilson

Primary specialty

OptometristTaxonomy code 152W00000X

License

49010032126 Issued in MI

Practice address

31114 Haggerty Rd
Farmington Hills, MI 48331-5803

Phone

(248) 788-1610

Fax

(248) 788-8290

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

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

Ferris State College - College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roy a Wilson OD PCGroup PAC ID 0143347658, 2 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 and National Provider Directory roles.

• Roy a. Wilson, OD, PC

  • Optometrist
  • Farmington Hills, MI
  • NPI 1356643084
  Medicare reassignment Care Compare group NPD Authorized official
• Medical Center Opticians

  • Optometrist
  • Warren, MI
  • NPI 1316067242
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1649287400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31114 HAGGERTY RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315803",
            "telephone_number": "248-788-1610",
            "fax_number": "248-788-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31114 HAGGERTY RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315803",
            "telephone_number": "248-788-1610",
            "fax_number": "248-788-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "49010032126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459590394",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "900F31045",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460850086",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900F368040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramello Wilson
• Rita Wilson
• Rita Wilson
• Robyn Wilson
• Roxanne Wilson
• Samantha Wilson
• Sandy Wilson
• Schenavia Wilson
• Semya Wilson
• Sequoya Wilson

• Optometrist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.