DR. DAVID T WHEELER M.D.
NPI 1255383121
Ophthalmology in Tigard, OR
NPI Status: Active since May 17, 2006
Contact Information
9735 SW SHADY LANE
SUITE 203
TIGARD, OR
ZIP 97223
Phone: (503) 635-4436
Fax: (503) 635-7356
- Individual
- Male
- Years of Experience 38
- Ophthalmology
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About DAVID WHEELER
This page provides the complete NPI Profile along with additional information for David Wheeler, a provider established in Tigard, Oregon with a medical specialization in Ophthalmology and more than 38 years of experience. He graduated from University Of California, San Diego School Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1255383121 assigned on May 2006. The practitioner's primary taxonomy code is 207W00000X with license number MD20807 (OR). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1255383121
- Provider Name
- DR. DAVID T WHEELER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 9735 SW SHADY LANE SUITE 203 TIGARD, OR 97223
- Location Phone
- (503) 635-4436
- Location Fax
- (503) 635-7356
- Mailing Address
- 9735 SW SHADY LANE SUITE 203 TIGARD, OR 97223
- Mailing Phone
- (503) 635-4436
- Mailing Fax
- (503) 635-7356
- Medical School Name
- UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
- Graduation Year
- 1988
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-17-2006
- Last Update Date
- 07-30-2014
- Code Navigator
Ophthalmologists like David Wheeler specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD20807
- License State
- OR
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- KP OR Bronze 6000 - EPO
- KP OR Bronze HSA 7100 - EPO
- KP OR Gold 0 - EPO
- KP OR Gold 1750 - EPO
- KP OR Silver 3000 - EPO
- KP OR Silver 4000 - EPO
- KP Oregon Standard Bronze Plan - EPO
- KP Oregon Standard Gold Plan - EPO
- KP Oregon Standard Silver Plan - EPO
- KP OR Family Dental - $100 Ded - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 150538 | MEDICAID (05) | OR | |
| 180040678 | OTHER (01) | RAILROAD MEDICARE | |
| W20355 | MEDICARE UPIN (02) | ||
| 107543 | MEDICARE ID-TYPE UNSPECIFIED (04) | OR |
Medicare Participation & PECOS Enrollment Status
David Wheeler is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
David Wheeler is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9335101500
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20100623000403
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient problem focused exam of visual system
Exam to measure eye deviation and range of motion
New patient problem focused exam of visual system
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.
This service was performed 48 times for 29 patientsThis is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.
This service was performed 113 times for 61 patientsA new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.
This service was performed 37 times for 37 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 97223 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.16
- Minimum New Patient Price $58.99
- Maximum New Patient Price $176.88
- Average New Patient Copayment $33.54
- Minimum New Patient Copayment $14.74
- Maximum New Patient Copayment $44.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $73.28
- Minimum Established Patient Price $19.32
- Maximum Established Patient Price $144.79
- Average Established Patient Copayment $18.32
- Minimum Established Patient Copayment $4.83
- Maximum Established Patient Copayment $36.19
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Wheeler is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| PROVIDENCE ST VINCENT MEDICAL CENTER | 9205 SW BARNES ROAD PORTLAND, OR 97225 | (503) 216-2213 | Acute Care Hospitals | |
| LEGACY EMANUEL MEDICAL CENTER | 2801 N GANTENBEIN AVENUE PORTLAND, OR 97227 | (503) 413-2200 | Acute Care Hospitals |
Reviews for DR. DAVID T WHEELER M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1255383121, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255383121, enumerated as an "individual" on May 17, 2006.
The provider is located at 9735 SW SHADY LANE SUITE 203 TIGARD, OR 97223 and the phone number is (503) 635-4436.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente, Moda. Please consult your insurance carrier or call the provider to verify.
David Wheeler is affiliated with: PROVIDENCE ST VINCENT MEDICAL CENTER and LEGACY EMANUEL MEDICAL CENTER.