Philip Joseph Wilson III, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2017021706 Issued in MO

Practice address

1241 W Stadium Blvd
Jefferson City, MO 65109-6023

Phone

(573) 556-7709

Fax

(573) 556-1709

NPI assigned

Jun 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Philip Joseph Wilson III Professional name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capitol Eye Care, Inc.Group PAC ID 3072613785, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.65 of 100Reported as group

Quality

100

Improvement activities

40

Cost

78.82

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Capitol Eye Care, Inc.

  • Specialist
  • Jefferson City, MO
  • NPI 1033239215
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962842476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W. STADIUM BLVD.",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096023",
            "telephone_number": "573-556-7709",
            "fax_number": "573-556-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096023",
            "telephone_number": "573-556-7709",
            "fax_number": "573-556-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PHILIP",
        "middle_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2017021706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029781",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILIP",
            "last_name": "WILSON",
            "middle_name": "JOSEPH",
            "suffix": "III",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamie Lynn Wilson, LMSW
• Joyce Marie Wilson, MD
• Michael D. Wilson, D.O.
• Nathan Pleas Wilson, MHS CCC-SLP
• Philip J. Wilson II, D.O.
• Sally A Wilson, RPH
• Samantha Marie Wilson
• Wanda Gayle Wilson, DO
• Heather Windham
• Larry D. Winegar, CRNA

• Ophthalmology Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.