DR. MICHAEL KENTON WILSON (OD) – Optometrist, NPI 1083140966

DR. MICHAEL KENTON WILSON (OD) is a healthcare provider. based in Belleville, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046011126 (IL). The NPI Number for DR. MICHAEL KENTON WILSON (OD) is 1083140966

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL KENTON WILSON (OD)
NPI
1083140966
Phone
(618) 235-4433
Address
3540 N Belt W Ste C
Enumeration Date
11 May 2017
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
6183273231
Graduation Year
2017 (9 years ago)
PAC ID
9133499700
Group Practice PAC ID
7214345735
Professional Enrollment ID
I20170714002039
Address ID
IL622631710NA250XXSTXX400
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

Provider Addresses for DR. MICHAEL KENTON WILSON (OD)

  • 3540 N Belt W Ste C

    Belleville, IL 622265975

    Phone: (618) 235-4433

    Fax: (618) 235-7483

    Type: Location

  • 250, Elm Street, Madison, Nashville, Davidson County, Tennessee, 37115, United States

    NASHVILLE, IL 622631710

    Phone: (618) 327-3231

    Fax: (618) 327-8748

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $526.

Total Amount is formed as General ($526) + Research ($0) + Ownership ($0) = $526.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($392).

Total Amount

$526

General + Research + Ownership

Payments

24

Total payment records

General Amount

$526

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

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: 2017-07-14

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
I20170714002039IOptometryILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens2,88227$0
92250Photography of the retina227216$0
92014Established patient complete exam of visual system189189$0
99213Established patient office or other outpatient visit, 20-29 minutes9364$0
99214Established patient office or other outpatient visit, 30-39 minutes6358$0
View full utilization report →

Insurance plans in this area (ZIP 62226)

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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: 7214345735View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YMO
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

Reviews

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Frequently asked questions

Where can patients find DR. MICHAEL KENTON WILSON (OD)'s NPI?
You can confirm DR. MICHAEL KENTON WILSON (OD) with NPI 1083140966; it appears in the national provider directory.
Is DR. MICHAEL KENTON WILSON (OD) active in the national directory?
DR. MICHAEL KENTON WILSON (OD)'s public NPI profile is in an active state.
Can you summarize DR. MICHAEL KENTON WILSON (OD)'s specialty in plain language?
Clinically, the directory lists DR. MICHAEL KENTON WILSON (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
Where does public data place DR. MICHAEL KENTON WILSON (OD)?
The snapshot lists Belleville, Illinois for DR. MICHAEL KENTON WILSON (OD); download NPPES for the complete set.
What if Belleville, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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