Individual provider Active NPI

Walter J. Chao, O.D., A.P.

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1063502565
Registry record updated Jul 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC-1819 Issued in FL
Practice address
7867 Pines Blvd
Pembroke Pines, FL 33024-6916
Phone
(954) 966-4335
Fax
(954) 966-4891
NPI assigned
Oct 13, 2006
Last updated
Jul 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC-1819 FL Primary
Pediatric Optometrist 152WP0200X OPC-1819 FL
Acupuncturist 171100000X AP466 FL

Addresses

Primary practice location

7867 Pines Blvd
Pembroke Pines, FL 33024-6916

Mailing address

7867 Pines Blvd
Pembroke Pines, FL 33024-6916
Phone (954) 966-4335

Other identifiers 1

IdentifierTypeStateIssuer
078481800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120716000362 FL Practitioner - Optometry 0648436865 Practice locations: Pemborke Pines, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7867 Pines Blvd
Pemborke Pines, FL 33024-6916
Phone (954) 966-4335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC-1819FLMDOptometrist
AP466FLMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372896000000",
    "number": "1063502565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7867 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246916",
            "telephone_number": "954-966-4335",
            "fax_number": "954-966-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7867 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246916",
            "telephone_number": "954-966-4335",
            "fax_number": "954-966-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAO",
        "first_name": "WALTER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D., A.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2013-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC-1819",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC-1819",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078481800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.