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DR. THOMAS PAUL COLVIN OD
NPI 1255079927
Optometrist in Wausau, WI

Active since May 23, 2022PECOS EnrolledAccepts Medicare Assignment
91.43/100
CMS Quality Rating
800 N 1ST ST, WAUSAU, WI 54403(715) 261-8500 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 17, 2025, May 23, 2022 (2 updates tracked since 2022).

About Dr. Thomas Paul Colvin Od NPPES

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

DR. THOMAS PAUL COLVIN OD (NPI 1255079927) is an individual optometrist in Wausau, Wisconsin, licensed in Wisconsin (3948-35) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (2022).

NPPES Registry Identity

NPI1255079927
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. THOMAS PAUL COLVINCredential: OD
Location Address800 N 1ST STWausau, WI 54403-4754
Mailing Address800 N 1st StWausau, WI 54403-4754 · (715) 261-8500
Phone(715) 261-8500
Sole ProprietorNo
Medical School CMSFerris State College - College Of OptometryGraduated 2022
Enumeration DateMay 23, 2022
Last NPPES UpdateNovember 17, 20252 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1255079927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in WI · 3948-35
Definition
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.
800 N 1ST ST, Wausau, WI 54403
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Louisiana 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. Thomas Paul Colvin Od 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 ID2961884622
PECOS Enrollment IDI20231121000708
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 8

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
394 services392 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
245 services168 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
156 services106 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
95 services95 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.
61 services48 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.
52 services47 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54403 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

91.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.38
Promoting Interoperability100
Improvement Activities40
Cost75.04

Other Providers at the Same Location NPPES 20

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

DR. CHRISTOPHER J KUCHARSKI M.D.
Ophthalmology
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500
DR. THADDEUS J KROLICKI M.D.
Ophthalmology
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500
DEEPAK SAMBHARA M.D.
Ophthalmology
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500
THOMAS BOOSTROM CRNA
Nurse Anesthetist, Certified Registered
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 362-2600
DR. DANIEL T. STOEHR O.D.
Optometrist
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500
EC LASER AND SURGERY INSTITUTE OF WI, LLC
Clinic/Center (Ambulatory Surgical)
800 N 1ST ST, SUITE 100
WAUSAU, WI 54403
Marathon County (715) 261-8500
CHRISTIANA LOREDANA GANDY M.D.
Ophthalmology (Glaucoma Specialist)
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500
DR. LORI J FISH
Audiologist
800 N 1ST ST
WAUSAU, WI 54403
Marathon County (715) 261-8500

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 Thomas Colvin's NPI number?

The NPI number for Thomas Colvin is 1255079927. It was assigned to this individual provider in the NPPES registry on May 23, 2022.

Where is Thomas Colvin located?

Thomas Colvin practices at 800 N 1st St, Wausau, WI 54403. The listed phone number is (715) 261-8500.

What is Thomas Colvin's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Thomas Colvin enrolled in Medicare?

Yes. Thomas Colvin 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 Thomas Colvin accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and HealthPartners and 2 other insurers list Thomas Colvin 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 Thomas Colvin was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.