Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1760477731 Individual Practitioner Male Practitioner

Dr. Jon Preston Wilson , OD

Optometrist • Roosevelt, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jon Wilson, OD is a certified Optometrist practicing in Roosevelt, UT. With approximately 25 years of clinical experience since graduating from Pacific University - College Of Optometry in 2001, Dr. Wilson delivers high-quality medical care to the local community at 165 W 200 N.

Dr. Wilson is affiliated with Roosevelt Vision Clinic Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, established patient complete exam of visual system, photography of the retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

165 W 200 N
71-7

Roosevelt, UT 840662834

Telephone 4357222981
Fax 4357223732
Associated Practice Facility / Clinic
🏢 Roosevelt Vision Clinic, Pc Facility NPI 1710973052

Medicare Profile & Education

Medical School

Pacific University - College Of Optometry

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Roosevelt, UT

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
25 Yrs +5.5 yrs vs City Avg
City Avg: 19.5 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
4 Specialists

Practicing in Roosevelt, UT (484 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
52.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilson (25 Years) 25 Yrs
Roosevelt Specialty Average (19.5 Years) 19.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
225 94 $119.00 $86.24
92014 Established patient complete exam of visual system
156 156 $155.70 $118.53
92250 Photography of the retina
116 105 $255.00 $34.82
67820 Removal of eyelashes using forceps
44 14 $109.00 $17.81
92083 Exam of visual field with extended testing
30 23 $123.00 $59.22
92134 Imaging of retina
30 18 $78.00 $37.98
66984 Removal of cataract with insertion of lens
24 15 $250.00 $101.51
92004 New patient complete exam of visual system
17 17 $186.00 $140.43
92133 Imaging of optic nerve
15 11 $78.00 $33.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
15 15 $72.00 $53.42

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License UT 4944063-9934

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbs
49440639900001 (UT)
Commercial Insurance / Payer ID Valucare
49440639900001 (UT)
Commercial Insurance / Payer ID Opticare
1015 (UT)
Commercial Insurance / Payer ID Pehp
67467
Commercial Insurance / Payer ID Medicare Legacy Number
000012521 (UT)
Commercial Insurance / Payer ID Vsp
870444057
Commercial Insurance / Payer ID Ntca
87041538400001
Commercial Insurance / Payer ID Eyemed
UT4063

Hospital & Practice Group Affiliations

Roosevelt Vision Clinic Pc

165 W 200, Roosevelt, UT 840662834

Roosevelt Vision Clinic Pc

165 W 200, Roosevelt, UT 840662834

Phone: 4357222981

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1780508606

Doctor of Optometry

NPI 1861487050

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 18, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location June 18, 2008

Registered at 165 W 200 N, 71-7, ROOSEVELT, UT 840662834 (Tel: 4357222981)

📍
Updated Business Mailing Address June 18, 2008

Registered at 165 W 200 N, 71-7, ROOSEVELT, UT 840662834 (Tel: 4357222981)

👤
Provider Name / Credentials Updated June 18, 2008

Recorded as JON WILSON, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 18, 2008

Optometrist (License #4944063-9934 in UT)

🟢
Initial NPI Registration & Enumeration September 15, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760477731
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2005
Last Update: June 18, 2008
Sole Proprietor: No

Mailing Address

165 W 200 N, 71-7

Roosevelt, UT 840662834

Phone: 4357222981

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.