1. Home
  2. Directory
  3. Florida
  4. Ponte Vedra Beach
  5. Optometrist
  6. NPI Profile

ROGER L. WILSON, O.D., P.A.
NPI 1164699054
Optometrist - Corneal and Contact Management in Ponte Vedra Beach, FL

Active since May 11, 2008
110 SOLANA RD, PONTE VEDRA BEACH, FL 32082(904) 280-2021(904) 280-2024 Get Directions Write a Review

NPPES record last updated: May 11, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Roger L. Wilson, O.d., P.a. NPPES

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

ROGER L. WILSON, O.D., P.A. (NPI 1164699054) is a healthcare organization registered as a corneal and contact management in Ponte Vedra Beach, Florida and active in the NPI registry since May 2008. The organization lists Roger L. Wilson, President, as its authorized official.

NPPES Registry Identity

NPI1164699054
Entity TypeOrganization
Primary Taxonomy152WC0802X
Legal Business NameROGER L. WILSON, O.D., P.A.
Location Address110 SOLANA RDPonte Vedra Beach, FL 32082-2230
Mailing Address110 Solana RdPonte Vedra Beach, FL 32082-2230 · (904) 280-2021 · Fax (904) 280-2024
Phone(904) 280-2021
Fax(904) 280-2024
Organization SubpartNo
Authorized OfficialRoger L. WilsonPresident · (904) 280-2021
Enumeration DateMay 11, 2008
✔ NPI 1164699054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Corneal and Contact ManagementEye and Vision Services Providers
Taxonomy Code152WC0802X
License✔ Licensed in FL · OP2569
Definition
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.
110 SOLANA RD, Ponte Vedra Beach, FL 32082
Open in Google Maps ↗

Other Identifiers 2

Medicare PINK7661FL
Medicare UPINU25956FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roger L. Wilson, O.d., P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Roger L. Wilson, O.D., P.A., which bills Medicare for the services this clinician delivers.

Clinician (1)

Roger Wilson, O.D.
Optometry
NPI 1215032370
110 SOLANA RD
Ponte Vedra Beach, FL 32082
(904) 280-2021
✔ PECOS✔ Accepts MedicareSame address

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

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 Roger L. Wilson, O.D., P.A.'s NPI number?

The NPI number for Roger L. Wilson, O.D., P.A. is 1164699054. It was assigned to this organization in the NPPES registry on May 11, 2008.

Where is Roger L. Wilson, O.D., P.A. located?

Roger L. Wilson, O.D., P.A. is located at 110 Solana Rd, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 280-2021.

What is Roger L. Wilson, O.D., P.A.'s specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Corneal and Contact Management, with taxonomy code 152WC0802X.

Is Roger L. Wilson, O.D., P.A. enrolled in Medicare?

Yes. Roger L. Wilson, O.D., P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roger L. Wilson, O.D., P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Roger L. Wilson, O.D., P.A.. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Roger L. Wilson, O.D., P.A. accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee and 1 other insurer list Roger L. Wilson, O.D., P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roger L. Wilson, O.D., P.A. was last updated on May 11, 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.