Individual provider Active NPI

Brian Johnson, OD

  • Optometrist
  • Wilmington, DE
National Provider Identifier
1770063687
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
I3-0011449 Issued in DE
Practice address
3509 Silverside Rd
Wilmington, DE 19810-4903
Phone
(302) 477-2608
Fax
(302) 477-2650
NPI assigned
Aug 20, 2018
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG003474 PA
Optometrist 152W00000X I3-0011449 DE Primary

Addresses

Primary practice location

3509 Silverside Rd
Wilmington, DE 19810-4903

Mailing address

3509 Silverside Rd
Wilmington, DE 19810-4903
Phone (302) 477-2621

Other practice location 1

4605 Kirkwood Hwy Ste A
Wilmington, DE 19808-5005
Phone (302) 999-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180924002280 PA Practitioner - Optometry 0547511909 Reassigns benefits to 1 organization
I20220812003084 DE Practitioner - Optometry 0547511909 Reassigns benefits to 3 organizations
I20260321000167 MD Practitioner - Optometry 0547511909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simon Eye Associates PAGroup PAC ID 4082684089, 35 clinicians

Practice addresses (Care Compare)

272 Carter Dr
Suite 100
Middletown, DE 19709-5850
Phone (302) 479-3937

304 N St
Suite 1
Elkton, MD 21921-5570
Phone (302) 239-1933

912 N Union St
Wilmington, DE 19805-5326
Phone (302) 239-1933

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003474PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Ophthalmology Consultants PA Optometrist CurrentSince Feb 3, 2025 Accepting new patients
Simon Eye Associates PA Optometrist CurrentSince Jan 1, 2026 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist Current Accepting new patients
Delaware Ophthalmology Consultants PA Optometrist CurrentSince Feb 3, 2025 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jul 12, 2022 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jul 12, 2022 Accepting new patients

Locations

885 S Governors Ave
Dover, DE 19904
Phone (302) 734-5861

272 Carter Dr
Ste 100
Middletown, DE 19709
Phone (302) 477-2626

3509 Silverside Rd
Wilmington, DE 19810
Phone (302) 477-2621

4605 Kirkwood Hwy
#A
Wilmington, DE 19808
Phone (302) 999-7171

5301 Limestone Rd
Ste 128
Wilmington, DE 19808

912 N Union St
Wilmington, DE 19805
Phone (302) 655-8180

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: bjohnson@doc.intellechartdirect.net

Organizations & group practices 7

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1770063687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 SILVERSIDE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104903",
            "telephone_number": "302-477-2621",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 SILVERSIDE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104903",
            "telephone_number": "302-477-2608",
            "fax_number": "302-477-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 Kirkwood Hwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198085005",
            "country_code": "US",
            "telephone_number": "302-999-7171",
            "fax_number": "302-993-7863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2025-07-14",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003474",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0011449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.