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WILDWOOD EYE CARE
NPI 1396073862
Optometrist in Marietta, GA

Active since November 22, 2009
1545 POWERS FERRY RD, SUITE 240, MARIETTA, GA 30067(770) 952-6412(770) 953-2738 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 1, 2024, Nov 4, 2020 (2 updates tracked since 2020).

About Wildwood Eye Care NPPES

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

WILDWOOD EYE CARE (NPI 1396073862) is a healthcare organization registered as an optometrist in Marietta, Georgia and active in the NPI registry since November 2009. The organization lists David Grosswald, Manager, as its authorized official.

NPPES Registry Identity

NPI1396073862
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameWILDWOOD EYE CARE LLC
Location Address1545 POWERS FERRY RD, SUITE 240Marietta, GA 30067-9412
Mailing Address1545 Powers Ferry Rd, Suite 240Marietta, GA 30067-9412 · (770) 952-6412 · Fax (770) 953-2738
Phone(770) 952-6412
Fax(770) 953-2738
Organization SubpartNo
Authorized OfficialDavid GrosswaldManager · (770) 952-6412
Enumeration DateNovember 22, 2009
Last NPPES UpdateAugust 1, 20242 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
✔ NPI 1396073862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
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.
1545 POWERS FERRY RD, Marietta, GA 30067
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Other Names 1

Other NameWildwood Eye Care

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wildwood Eye Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Wildwood Eye Care, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Nicole Mardak, O.D.
Optometry
NPI 1033551767
1545 POWERS FERRY RD SE SUITE 240
Marietta, GA 30067
(770) 952-6412
✔ PECOS✔ Accepts MedicareSame address
Stuart Tasman, OD
Optometry
NPI 1073548426
1545 POWERS FERRY RD SE STE 240
Marietta, GA 30067
(770) 952-6412
✔ PECOS✔ Accepts Medicare0.1 mi
Heather Zutaut, O.D.
Optometry
NPI 1699709246
1545 POWERS FERRY RD SE
Marietta, GA 30067
(770) 952-6412
✔ PECOS✔ Accepts Medicare0.1 mi
Patrick Dicus, OD
Optometry
NPI 1093494379
7661 N POINT PKWY
Alpharetta, GA 30022
(470) 277-6311
✔ PECOS13 mi
Karla Thomason, O.D.
Optometry
NPI 1598107682
76 BETHEL DRIVE
Dawsonville, GA 30534
(706) 531-9900
✔ PECOS42 mi

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 Wildwood Eye Care LLC's NPI number?

The NPI number for Wildwood Eye Care LLC is 1396073862. It was assigned to this organization in the NPPES registry on November 22, 2009. The provider is also known as Wildwood Eye Care.

Where is Wildwood Eye Care LLC located?

Wildwood Eye Care LLC is located at 1545 Powers Ferry Rd Suite 240, Marietta, GA 30067. The listed phone number is (770) 952-6412.

What is Wildwood Eye Care LLC's specialty?

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

Is Wildwood Eye Care LLC enrolled in Medicare?

Yes. Wildwood Eye Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wildwood Eye Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Optometry, reassign their Medicare billing to Wildwood Eye Care LLC. 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Wildwood Eye Care LLC was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.