Individual provider Active NPI

James E Wilson, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1669517306
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001602 Issued in IN
Practice address
10610 N Pennsylvania St
Ste B
Indianapolis, IN 46280-2000
Phone
(317) 844-6269
Fax
(317) 815-7567
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001602 IN Primary

Addresses

Primary practice location

10610 N Pennsylvania St
Ste B
Indianapolis, IN 46280-2000

Mailing address

10610 Pennsylvania Street
Suite B
Indianapolis, IN 46280
Phone (317) 844-6269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20111027000055 IN Practitioner - Optometry 4688847205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lanter Eyecare and Laser Surgery PCGroup PAC ID 7113906652, 5 clinicians

Practice addresses (Care Compare)

10610 N Pennsylvania St
Suite 102
Carmel, IN 46280-2000
Phone (317) 844-6269

Merit-based Incentive Payment System (MIPS)

Final score
97.84 of 100Reported as group
Quality
95.68
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001602INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lanter Eyecare and Laser Surgery PC Optometrist CurrentSince Aug 1, 1995 Accepting new patients

Locations

10610 N Pennsylvania St
Ste B
Carmel, IN 46280
Phone (317) 844-6269

10610 N Pennsylvania St
Ste 102
Carmel, IN 46280
Phone (317) 844-6269

1550 E County Line Rd
#326
Indianapolis, IN 46227
Phone (317) 887-7777

Organizations & group practices 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1669517306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10610 PENNSYLVANIA STREET",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46280",
            "telephone_number": "317-844-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 N PENNSYLVANIA ST",
            "address_2": "STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802000",
            "telephone_number": "317-844-6269",
            "fax_number": "317-815-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.