Individual provider Active NPI

Michele Elizabeth Wasilauski, OD

  • Optometrist
  • Kingston, PA
National Provider Identifier
1730149915
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000327 Issued in PA
Practice address
703 Rutter Ave
Kingston, PA 18704-4801
Phone
(570) 288-7405
Fax
(570) 288-7406
NPI assigned
Mar 23, 2006
Last updated
Feb 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000327 PA Primary

Addresses

Primary practice location

703 Rutter Ave
Kingston, PA 18704-4801

Mailing address

703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405

Other identifiers 1

IdentifierTypeStateIssuer
001881535MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101122000880 PA Practitioner - Optometry 0840486452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405

Merit-based Incentive Payment System (MIPS)

Final score
85.08 of 100Reported as group
Quality
85.29
Promoting interoperability
100
Improvement activities
40
Cost
64.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Innovation Centers of PA LLC CurrentSince Jan 1, 2020 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Current Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Past Accepting new patients

Locations

2661 Riva Rd
Ste 1030
Annapolis, MD 21401

703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405

170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1730149915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASILAUSKI",
        "first_name": "MICHELE",
        "middle_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001881535",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.