Individual provider Active NPI

Michael Andrew Wiles, OD

  • Optometrist
  • Moore, OK
National Provider Identifier
1689057648
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2873 Issued in OK
Practice address
2909 S Telephone Rd
Moore, OK 73160-2937
Phone
(405) 735-7510
NPI assigned
Jul 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2873 OK Primary

Addresses

Primary practice location

2909 S Telephone Rd
Moore, OK 73160-2937

Mailing address

2909 S Telephone Rd
Moore, OK 73160-2937
Phone (405) 735-7510

Other practice location 1

10801 S Western Ave Ste 200
Oklahoma City, OK 73170-6222
Phone (405) 703-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20150914002639 OK Practitioner - Optometry 2062729627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of Oklahoma PLLCGroup PAC ID 3173522596, 14 clinicians

Practice addresses (Care Compare)

2909 S Telephone Rd
Eye Associates of Oklahoma
Moore, OK 73160-2937
Phone (405) 799-7510

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
96.81
Improvement activities
40
Cost
54.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2873OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Oklahoma PLLC Optometrist CurrentSince Nov 6, 2022 Accepting new patients

Locations

10801 S Western Ave
Ste 200
Oklahoma City, OK 73170
Phone (405) 703-8404

1455 S Douglas Blvd
Ste D
Oklahoma City, OK 73130
Phone (405) 733-4545

Organizations & group practices 2

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": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689057648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602937",
            "telephone_number": "405-735-7510",
            "fax_number": "405-702-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602937",
            "telephone_number": "405-735-7510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10801 S Western Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731706222",
            "country_code": "US",
            "telephone_number": "405-703-8404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILES",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.