LAURA WILSHIRE (OD) – Optometrist, NPI 1063965515

LAURA WILSHIRE (OD) is a healthcare provider. based in Peoria, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046-011052 (IL). The NPI Number for LAURA WILSHIRE (OD) is 1063965515

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
LAURA WILSHIRE (OD)
NPI
1063965515
Phone
(309) 693-9540
Address
8309 N KNOXVILLE AVE
Enumeration Date
2 August 2016
Last Update Date
2 August 2016

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
3096830500
Graduation Year
2016 (10 years ago)
PAC ID
2567758279
Group Practice PAC ID
3678814217
Professional Enrollment ID
I20160907000329
Address ID
IL616153511PE5116XRDXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for LAURA WILSHIRE (OD)

  • 8309, North Knoxville Avenue, Peoria, Peoria County, Illinois, 61615, United States

    PEORIA, IL 616152170

    Phone: (309) 693-9540

    Fax: (309) 693-9754

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $311.

Total Amount is formed as General ($311) + Research ($0) + Ownership ($0) = $311.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($170).

Total Amount

$311

General + Research + Ownership

Payments

6

Total payment records

General Amount

$311

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-09-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160907000329IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61615)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678814217View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YTN
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YCO
O P T O M E T R YIL

Reviews

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Frequently asked questions

Is LAURA WILSHIRE (OD) listed with a National Provider Identifier?
Yes — LAURA WILSHIRE (OD) has NPI 1063965515 on file in the registry.
Would LAURA WILSHIRE (OD) appear as active to a payer?
You can treat LAURA WILSHIRE (OD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe LAURA WILSHIRE (OD)'s focus?
For LAURA WILSHIRE (OD), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LAURA WILSHIRE (OD)?
Travel planning: use Peoria, Illinois as the reference point for LAURA WILSHIRE (OD), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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