Individual provider Active NPI

Wesley Thomas Mayes, O.D.

  • Optometrist
  • Pensacola, FL
National Provider Identifier
1780876862
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4224 Issued in FL
Practice address
9050 University Pkwy
Pensacola, FL 32514-5524
Phone
(850) 266-7500
NPI assigned
Aug 13, 2007
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 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 OPC 4224 FL Primary

Addresses

Primary practice location

9050 University Pkwy
Pensacola, FL 32514-5524

Mailing address

9050 University Pkwy
Pensacola, FL 32514-5524
Phone (850) 266-7500

Other identifiers 2

IdentifierTypeStateIssuer
36139OtherFLBLUE CROSS AND BLUE SHIELD OF FLORIDA
2799677MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080805000186 FL Practitioner - Optometry 3375617657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magruder Eye Institute, PLLCGroup PAC ID 3971582024, 23 clinicians

Practice addresses (Care Compare)

9050 University Pkwy
Pensacola, FL 32514-5524
Phone (850) 266-7500

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4224FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Ophthalmic Affiliates, PA CurrentSince Nov 1, 2017 Accepting new patients
Magruder Eye Institute, PLLC CurrentSince Jan 24, 2023 Accepting new patients
Eye Care Physicians Inc PastSince Oct 7, 2013 Accepting new patients

Locations

182 E Redstone Ave
Ste A
Crestview, FL 32539
Phone (850) 266-7500

1300 Shoreline Dr
Ste 104
Gulf Breeze, FL 32561
Phone (850) 932-8774

1911 N Mills Ave
Orlando, FL 32803
Phone (407) 893-8200

9050 University Pkwy
Pensacola, FL 32514
Phone (850) 266-7500

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1780876862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 UNIVERSITY PKWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145524",
            "telephone_number": "850-266-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 UNIVERSITY PKWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145524",
            "telephone_number": "850-266-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES",
        "first_name": "WESLEY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF FLORIDA",
            "identifier": "36139",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2799677",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.