Active NPI
Jeffrey Robert Wilson, M.D.
- Urology Physician
- Ontario, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35.148953
- Practice address
- 715 Richland Mall
Ontario, OH 44906-3802 - Phone
- (419) 468-0732
- Fax
- (419) 563-9862
- NPI assigned
- Jun 15, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD450932 | PA | |
| Urology Physician | 208800000X | 35.148953 | OH | Primary |
Addresses
Primary practice location
715 Richland Mall
Ontario, OH 44906-3802
Mailing address
700 N Columbus St
Crestline, OH 44827-1455
Phone (419) 462-3485
Other practice location 1
629 N Sandusky Ave
Bucyrus, OH 44820-1821
Phone (419) 468-0732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Ohio State University College of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
269 Portland Way S
Galion, OH 44833-2312
Phone (419) 468-4841
2981 W 4TH St
Ontario, OH 44906-1267
Phone (419) 468-0505
629 N Sandusky Ave
Bucyrus, OH 44820-1821
Phone (419) 562-4677
715 Richland Mall
Ontario, OH 44906-3802
Phone (567) 307-7557
987 State Route 97
Bellville, OH 44813-7001
Phone (567) 560-3790
Hospital & facility affiliations
- Avita Ontario
- Bucyrus Community Hospital
- Galion Community Hospital
- Ohiohealth Mansfield Hospital
- Marion General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 19 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16952 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Group Rhodes P C | Current | Accepting new patients | |
| Optum Medical Group Rhodes P C | Current | Accepting new patients |
Locations
58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000
2010 Wellness Way
Ste 200
Las Vegas, NV 89106
Phone (702) 382-2900
6190 S Fort Apache Rd
Las Vegas, NV 89148
Phone (702) 485-5885
Interoperability endpoints
- jwilson7027@direct.osumc.edu
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 and National Provider Directory roles.
-
- Specialist
- Galion, OH
- NPI 1689822827
-
- Specialist
- Las Vegas, NV
- NPI 1063458594
-
- Radiation Oncology Physician
- Las Vegas, NV
- NPI 1225609464
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ontario, OH
- NPI 1790131050
-
- Critical Access Hospital
- Bucyrus, OH
- NPI 1104914274
-
- Critical Access Hospital
- Galion, OH
- NPI 1215907522
-
- General Acute Care Hospital
- Marion, OH
- NPI 1215935366
-
- General Acute Care Hospital
- Mansfield, OH
- NPI 1790837235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1962639237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 N COLUMBUS ST",
"city": "CRESTLINE",
"state": "OH",
"postal_code": "448271455",
"telephone_number": "419-462-3485",
"fax_number": "419-462-4582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 RICHLAND MALL",
"city": "ONTARIO",
"state": "OH",
"postal_code": "449063802",
"telephone_number": "419-468-0732",
"fax_number": "419-563-9862"
}
],
"practiceLocations": [
{
"address_1": "629 N Sandusky Ave",
"address_purpose": "LOCATION",
"city": "Bucyrus",
"state": "OH",
"postal_code": "448201821",
"country_code": "US",
"telephone_number": "419-468-0732",
"fax_number": "419-563-9862",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "JEFFREY",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-15",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MD450932",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OH",
"license": "35.148953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.