Dovilan Wyatt, M.D

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

336087473 Issued in IL

Practice address

8741 S Greenwood Ave
Ste 106
Chicago, IL 60619-7061

Phone

(773) 933-0276

Fax

(773) 933-0278

NPI assigned

Mar 30, 2007

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in IL, OH2 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

Specialty

Ophthalmology

Education

Wright State University Boonshoft School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Eye Care, Inc.Group PAC ID 6103850581, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dovilan.wyatt.1@13511.direct.athenahealth.com
• FHIR API: https://app.meldrx.com/api/fhir/ei-spectrum

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.

• Spectrum Eye Care, Inc.

  • Ophthalmology Physician
  • Findlay, OH
  • NPI 1821095381

  OH, Ophthalmology

  Medicare reassignment Care Compare group NPD
• Spectrum Eye Care Inc

  • Eyewear Supplier
  • Findlay, OH
  • NPI 1396828067

  Ophthalmology

  NPD
• Alicia Stovell, M.D. PC

  • Exclusive Provider Organization
  • Chicago, IL
  • NPI 1235329749
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Blanchard Valley Regional Health Center

  • General Acute Care Hospital
  • Findlay, OH
  • NPI 1710920327

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1679693097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8741 S GREENWOOD AVE STE 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197058",
            "telephone_number": "773-933-0676",
            "fax_number": "773-933-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8741 S GREENWOOD AVE",
            "address_2": "STE 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197061",
            "telephone_number": "773-933-0276",
            "fax_number": "773-933-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "DOVILAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "336087473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036126197",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01130502",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Howard Wurster, MD
• Rebecca Marion Wurtz, MD
• WX Medical Center Corp
• Cameron Wyant, LPC
• Amanda Wyatt, MPT
• Helen Wyatt
• James Kelley Wyatt, PH.D.
• Joel Daniel Wyatt, MS
• Laura Wyatt
• Matthew Monroe Wyatt, M.D.

• Ophthalmology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.