Individual provider Active NPI

Constance L Woldorff, OD

  • Optometrist
  • Durham, NC
National Provider Identifier
1205819554
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1823 Issued in NC
Practice address
813 Broad St
Durham, NC 27705-4137
Phone
(919) 381-5365
Fax
(919) 381-5366
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1823 NC Primary

Addresses

Primary practice location

813 Broad St
Durham, NC 27705-4137

Mailing address

813 Broad St
Durham, NC 27705-4137
Phone (919) 381-5365

Other identifiers 2

IdentifierTypeStateIssuer
NC5878B122OtherNCMEDICARE PTAN
89093K1MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040819001557 NC Practitioner - Optometry 8224002993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

813 Broad St
Durham, NC 27705-4137
Phone (919) 381-5365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Woldorff Family Optometry PA Optometrist CurrentSince Jun 28, 2010 Accepting new patients
Optometric Eye Care Center of Durham PA Optometrist Past Accepting new patients

Locations

813 Broad St
Durham, NC 27705
Phone (919) 381-5365

Organizations & group practices 2

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1205819554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054137",
            "telephone_number": "919-381-5365",
            "fax_number": "919-381-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054137",
            "telephone_number": "919-381-5365",
            "fax_number": "919-381-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDORFF",
        "first_name": "CONSTANCE",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC5878B122",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093K1",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.