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THEODORE M WANDZILAK MD
NPI 1013909753
Ophthalmology in Louisville, KY

Active since August 18, 2005PECOS Enrolled
1348 POPLAR LEVEL RD, LOUISVILLE, KY 40217(502) 634-8100(502) 637-6396 Get Directions Write a Review

NPPES record last updated: January 9, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Theodore M Wandzilak Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE M WANDZILAK MD (NPI 1013909753) is an individual ophthalmology provider in Louisville, Kentucky, licensed in Kentucky (22152) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013909753
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTHEODORE M WANDZILAKCredential: MD
Location Address1348 POPLAR LEVEL RDLouisville, KY 40217-1307
Mailing Address1348 Poplar Level RdLouisville, KY 40217-1307 · (502) 634-8100 · Fax (502) 637-6396
Phone(502) 634-8100
Fax(502) 637-6396
Sole ProprietorYes
Enumeration DateAugust 18, 2005
Last NPPES UpdateJanuary 9, 2008
✔ NPI 1013909753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in KY · 22152
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1348 POPLAR LEVEL RD, Louisville, KY 40217
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Other Identifiers 4

Medicare NSC0242010001
Medicare ID-Type Unspecified1430501KY
Medicare UPINC72335KY
Medicaid64221526KY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore M Wandzilak Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theodore Wandzilak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kentucky Eye Surgery Associates Psc
5.1 mi
Ophthalmology
4940 HAZELWOOD AVENUE
Louisville, KY 40214
  • Reassigned Medicare billing, Kentucky enrollment
  • 6 clinicians in this Medicare group
NPI 1588862361 (502) 368-3937

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40217 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THEODORE M WANDZILAK MD
Durable Medical Equipment & Medical Supplies
1348 POPLAR LEVEL RD
LOUISVILLE, KY 40217
Jefferson County (502) 634-1721

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Wandzilak's NPI number?

The NPI number for Theodore Wandzilak is 1013909753. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Where is Theodore Wandzilak located?

Theodore Wandzilak practices at 1348 Poplar Level Rd, Louisville, KY 40217. The listed phone number is (502) 634-8100.

What is Theodore Wandzilak's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Theodore Wandzilak enrolled in Medicare?

Yes. Theodore Wandzilak is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theodore Wandzilak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Wandzilak reassigns Medicare benefits to Kentucky Eye Surgery Associates Psc (Louisville, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theodore Wandzilak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Theodore Wandzilak was last updated on January 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.