DR. ROGER J WILSON (NPI# 1609087717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609087717 |
| Entity Type | Individual |
| Full Name | DR. ROGER J WILSON |
| Credential | O.D. |
| Practice Address |
940 Commonwealth Ave Suite 2 Boston MA 02215-1203 |
| Practice Telephone | 6175875511 |
| Practice Fax Number | 6175875512 |
| Mailing Telephone | 6175875511 |
| Mailing Fax Number | 6175875512 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2852 | MA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861573594 | Roger Dale Wilson | Dentist | 8345 Walnut Hill Ln Ste 100, Dallas, TX 75231-4246 | 2006-10-18 |
| 1245325794 | Roger M Wilson | Psychiatry & Neurology | Dorothea Dix Agency, Bangor, ME 04401 | 2006-10-03 |
| 1215032370 | Roger L. Wilson | Optometrist | 110 Solana Rd, Ponte Vedra Beach, FL 32082-2230 | 2006-09-14 |
| 1427064385 | Roger W Wilson | Optometrist | 1551 E Stop 12 Rd, Indianapolis, IN 46227-1006 | 2006-07-31 |
| 1851372775 | Roger W Wilson | Chiropractor | 200 Park Pl, Chagrin Falls, OH 44022-4456 | 2005-11-08 |
| 1598801896 | Roger Wilson | Case Manager/Care Coordinator | 30 Tremont St, Boscawen, NH 03303-1328 | 2007-01-30 |
| 1851475297 | Roger Lewis Wilson | Optometrist | 7721 E Main St, Reynoldsburg, OH 43068-1211 | 2006-10-24 |
| 1528001062 | Roger Wilson | Radiology | 2020 Palomino Ln, Suite 100, Las Vegas, NV 89106-4812 | 2006-06-13 |
| 1710931076 | Roger Wilson | Orthopaedic Surgery | 1140 W La Veta Avenue, Suite 860, Orange, CA 92868 | 2006-05-20 |
| 1437125721 | Roger Cave Wilson | Dentist | 3415 5th St, Rapid City, SD 57701-7365 | 2006-02-27 |
| Street Address |
940 COMMONWEALTH AVE SUITE 2 |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952547234 | Grace Elizabeth Lytle | Optometrist | 940 Commonwealth Ave, Suite 2a, Boston, MA 02215-1203 | 2008-12-17 |
| 1356598080 | Meng Meng Xu | Optometrist | 940 Commonwealth Ave, Suite 2, Boston, MA 02215-1203 | 2008-08-25 |
| 1851556021 | Jacky Kin Wai Kong | Optometrist | 940 Commonwealth Ave, Boston, Boston, MA 02215-1203 | 2008-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790314557 | Kirsten Brady | Optometrist | 10 Fairfield St Apt 3, Boston, MA 02116-1666 | 2020-04-03 |
| 1922647403 | Claudia Christine Evans | Optometrist | 8 Gloucester St, Boston, MA 02115-1720 | 2019-12-31 |
| 1437790813 | Arianna Yoshiko Jordan | Optometrist | 83 Newbury St Ste 3, Boston, MA 02116-3284 | 2019-10-07 |
| 1528628625 | Molly Jean Admire | Optometrist | 31 Saint James Ave Ste 135, Boston, MA 02116-4101 | 2019-06-19 |
| 1770097040 | Doug Haigh Eye Care LLC | Optometrist | 588 E 7th St, Boston, MA 02127-4224 | 2017-11-25 |
| 1487108585 | Alina Reznik | Optometrist | 33 Arch St Fl 16, Boston, MA 02110-1424 | 2016-08-08 |
| 1417326182 | Darryl Grace & Associates PC | Optometrist | 101 Arch St, Cohen's Fashion Optical, Boston, MA 02110-1130 | 2015-09-23 |
| 1437535895 | Xueling Song | Optometrist | 155 Federal St # 150, Boston, MA 02110-1727 | 2015-08-07 |
| 1699165357 | Azadeh Kelly | Optometrist | 33 Broad St Lbby 2, Boston, MA 02109-4229 | 2015-02-02 |
| 1164825428 | Rachel Bates | Optometrist | 513 Beacon St, Apt 10, Boston, MA 02215-2309 | 2014-10-01 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.