Individual provider Active NPI

Benjamin Joseph Wheeler, O.D.

  • Optometrist
  • Bronx, NY
National Provider Identifier
1104011485
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007387 Issued in NY
Practice address
138 E Fordham Rd
Bronx, NY 10468-5408
Phone
(615) 430-6758
Fax
(718) 364-7300
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007387 NY Primary
Optometrist 152W00000X 2780 TN

Addresses

Primary practice location

138 E Fordham Rd
Bronx, NY 10468-5408

Mailing address

428 W 48TH St
Apt 1 Re
New York, NY 10036
Phone (615) 430-6758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20101102001034 TN Practitioner - Optometry 1456545508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007387NYMDOptometrist
2780TNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ky Doctors of Optometry, PLLC Optometrist CurrentSince Apr 6, 2011 Accepting new patients
Dr. Mark Lynn & Associates, PLLC Optometrist CurrentSince Apr 6, 2011 Accepting new patients
Eyecare Plus CL PLLC Optometrist PastSince Oct 14, 2006 Accepting new patients
Eyecare Plus Ca,PLLC Optometrist PastSince Jul 20, 2008 Accepting new patients
Calvert Opthalmology PSC Past Accepting new patients
519 Eyecare Inc. Optometrist Past Accepting new patients
Eyecare Plus HH, PLLC Optometrist PastSince Sep 1, 2003 Accepting new patients

Locations

1701 Gallatin Pike N
Madison, TN 37115
Phone (615) 868-2000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1104011485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 W 48TH ST",
            "address_2": "APT 1 RE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10036",
            "telephone_number": "615-430-6758",
            "fax_number": "718-364-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685408",
            "telephone_number": "615-430-6758",
            "fax_number": "718-364-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007387",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.