Active NPI
Thomas Matlock Wyman, OD
- Optometrist
- Prince George, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618003067
- Practice address
- 2015 Waterside Rd
Prince George, VA 23875-1265 - Phone
- (804) 287-4200
- NPI assigned
- Sep 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618003067 | VA | Primary |
Addresses
Primary practice location
2015 Waterside Rd
Prince George, VA 23875-1265
Mailing address
202 Windmere Dr
Colonial Heights, VA 23834-2151
Phone (385) 204-1718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2015 Waterside Rd
Prince George, VA 23875-1265
Phone (804) 287-4200
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.26 of 100
- Quality
- 81.98
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 66.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Surgeons of Richmond, Inc. | Current | Accepting new patients | |
| Eye Surgeons of Richmond, Inc. | Current | Accepting new patients | |
| Eye Surgeons of Richmond, Inc. | Optometrist | Current | Accepting new patients |
| Virginia Eye Institute Inc | Past | Accepting new patients |
Locations
11601 Iron Bridge Rd
Ste 104
Chester, VA 23831
Phone (804) 285-5330
11601 Iron Bridge Rd
Ste 200
Chester, VA 23831
Phone (804) 340-5730
8120 Pleasant Grove Rd
Ste 100
Mechanicsville, VA 23116
611 Watkins Centre Pkwy
Ste 100
Midlothian, VA 23114
Phone (804) 287-4412
2015 Waterside Rd
Prince George, VA 23875
Phone (804) 733-7300
6946 Forest Ave
Ste 100
Richmond, VA 23230
Phone (804) 287-2020
12018 W Broad St
Ste 102
Richmond, VA 23233
Phone (804) 287-2022
400 Westhampton Sta
Richmond, VA 23226
6946 Forest Ave
Richmond, VA 23230
Phone (804) 287-2020
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AICDBD
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.
-
- Eyewear Supplier
- Richmond, VA
- NPI 1033625744
-
- Ophthalmology Physician
- Richmond, VA
- NPI 1699270496
-
- Ambulatory Surgical Clinic/Center
- Richmond, VA
- NPI 1053336602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1881362960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 WINDMERE DR",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238342151",
"telephone_number": "385-204-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 WATERSIDE RD",
"city": "PRINCE GEORGE",
"state": "VA",
"postal_code": "238751265",
"telephone_number": "804-287-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYMAN",
"first_name": "THOMAS",
"middle_name": "MATLOCK",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-02",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618003067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Prince George, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.