Individual provider Active NPI

Stephen Matthew Wetick, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1770736720
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2821 Issued in TN
Practice address
1245 Madison Ave
Memphis, TN 38104-2211
Phone
(901) 722-3250
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2821 TN Primary

Addresses

Primary practice location

1245 Madison Ave
Memphis, TN 38104-2211

Mailing address

5350 Poplar Ave
Suite 950
Memphis, TN 38119-3699
Phone (901) 683-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090716000446 TN Practitioner - Optometry 7517019854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Eye PLCGroup PAC ID 1456387158, 3 clinicians

Practice addresses (Care Compare)

8120 US Hwy 51 N
Suite 6
Millington, TN 38053-1702
Phone (901) 872-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
86.03
Improvement activities
40
Cost
74.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2821TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Co LLC Optometrist CurrentSince Jun 1, 2025 Accepting new patients
Eye Specialists Association PC CurrentSince Nov 22, 2023 Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Jun 1, 2025 Accepting new patients
West Tennessee Eye PLC Optometrist Past Accepting new patients

Locations

7865 Trinity Rd
Ste 104
Cordova, TN 38018
Phone (901) 753-7100

1900 Kirby Pkwy
Ste 100B
Germantown, TN 38138
Phone (901) 754-0930

4260 Fort Henry Dr
Ste 16
Kingsport, TN 37663
Phone (423) 246-6317

Interoperability endpoints

  • Direct secure messaging: drwetick@esg.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1770736720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 POPLAR AVE",
            "address_2": "SUITE 950",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193699",
            "telephone_number": "901-683-4600",
            "fax_number": "901-683-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETICK",
        "first_name": "STEPHEN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.