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DR. WILLIAM LEWIS GILMER JR. M.D.
NPI 1194961151
Ophthalmology in Port Orange, FL

Active since December 22, 2008PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
5111 S RIDGEWOOD AVE, SUITE 104, PORT ORANGE, FL 32127(386) 256-1212(386) 256-1213 Get Directions Write a Review

NPPES record last updated: March 18, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. William Lewis Gilmer Jr. M.d. NPPES

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

DR. WILLIAM LEWIS GILMER JR. M.D. (NPI 1194961151) is an individual ophthalmology provider in Port Orange, Florida, licensed in Florida (ME0111581) and active in the NPI registry since December 2008. He is enrolled in Medicare PECOS, is affiliated with Adventhealth New Smyrna Beach, and is a graduate of Georgetown University School Of Medicine (2005).

NPPES Registry Identity

NPI1194961151
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. WILLIAM LEWIS GILMER JR.Credential: M.D.
Location Address5111 S RIDGEWOOD AVE, SUITE 104Port Orange, FL 32127-5169
Mailing Address5111 S Ridgewood Ave, Suite 104Port Orange, FL 32127-5169 · (386) 256-1212 · Fax (386) 256-1213
Phone(386) 256-1212
Fax(386) 256-1213
Sole ProprietorYes
Medical School CMSGeorgetown University School Of MedicineGraduated 2005
Enumeration DateDecember 22, 2008
Last NPPES UpdateMarch 18, 2016
✔ NPI 1194961151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in FL · ME0111581
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.
5111 S RIDGEWOOD AVE, Port Orange, FL 32127
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Other Identifiers 1

Medicaid008424200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. William Lewis Gilmer Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42362535
PECOS Enrollment IDI20120125000796
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.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,118 services646 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
808 services613 patients
Exam of the internal drainage system of eye 92020
This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.
466 services412 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
442 services364 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
429 services354 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
277 services201 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth New Smyrna Beach

Acute Care Hospitals · New Smyrna Beach, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100014
Location401 Palmetto StNew Smyrna Beach, FL 32170 · Volusia County
Emergency services

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100068
Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32127 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
96%127 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
69%127 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
94%2,780 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
86%850 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
8%2,549 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%2,642 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
98%1,158 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
90%807 patients5/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
51%541 patients3/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 85% · 675 patients
88%675 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
66%1,158 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
4%1,158 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 807 patients
0%807 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

DR. LARS LANDERS D.C.
Chiropractor (Neurology)
5111 S RIDGEWOOD AVE, SUITE 102
PORT ORANGE, FL 32127
Volusia County (386) 366-8198
RALPH JOSEPH ZWOLINSKI MD
Psychiatry & Neurology (Neurology)
5111 S RIDGEWOOD AVE, SUITE 102
PORT ORANGE, FL 32127
Volusia County (386) 763-4484
WL GILMER, MD, PA
Ophthalmology
5111 S RIDGEWOOD AVE, SUITE 104
PORT ORANGE, FL 32127
Volusia County (386) 256-1212
DR. MATTHEW DAVID LOWRY D.C.
Chiropractor
5111 S RIDGEWOOD AVE, SUITE 103
PORT ORANGE, FL 32127
Volusia County (386) 310-8766
NEUROLOGY & SPINE DISORDERS LLC
Psychiatry & Neurology (Neurology)
5111 S RIDGEWOOD AVE, SUITE 102
PORT ORANGE, FL 32127
Volusia County (386) 763-4484

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 William Gilmer's NPI number?

The NPI number for William Gilmer is 1194961151. It was assigned to this individual provider in the NPPES registry on December 22, 2008.

Where is William Gilmer located?

William Gilmer practices at 5111 S Ridgewood Ave Suite 104, Port Orange, FL 32127. The listed phone number is (386) 256-1212.

What is William Gilmer's specialty?

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

Is William Gilmer enrolled in Medicare?

Yes. William Gilmer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does William Gilmer accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and Oscar Health Maintenance Organization of Florida list William Gilmer 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.

Is William Gilmer affiliated with any hospitals?

According to CMS data, William Gilmer is affiliated with Adventhealth New Smyrna Beach and Adventhealth Daytona Beach.

When was this NPI record last updated?

The NPPES record for William Gilmer was last updated on March 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.