Organization Active NPI

Walesby Vision Center P a

  • Vision Therapy Optometrist
  • Oldsmar, FL
National Provider Identifier
1265719066
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
Legal business name
WALESBY VISION CENTER P A
Practice address
253 Pine Ave N Unit B
Oldsmar, FL 34677-4630
Phone
(813) 915-0755
Fax
(813) 915-0704
NPI assigned
Nov 8, 2011
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Dr. Nicholas Thomas, ODNPI 1356743272
Title
Owner/President
Phone
(813) 915-0755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WV0400X Primary

Addresses

Primary practice location

253 Pine Ave N Unit B
Oldsmar, FL 34677-4630

Mailing address

253 Pine Ave N Unit B
Oldsmar, FL 34677-4630
Phone (813) 915-0755

Other identifiers 1

IdentifierTypeStateIssuer
084909000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120112000338 FL Part B Supplier - Clinic/Group Practice 3971718263 Receives reassigned benefits from 3 practitioners
Practice locations: Lutz, FL

National Provider Directory

National Provider Directory
Tax ID family
Walesby Vision Center P a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24444 State Road 54
Lutz, FL 33559
Phone (813) 345-8544

253 Pine Ave N
#B
Oldsmar, FL 34677
Phone (813) 915-0755

2510 W Waters Ave
Tampa, FL 33614
Phone (813) 915-0755

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1265719066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 PINE AVE N UNIT B",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774630",
            "telephone_number": "813-915-0755",
            "fax_number": "813-915-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 PINE AVE N UNIT B",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774630",
            "telephone_number": "813-915-0755",
            "fax_number": "813-915-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALESBY VISION CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-915-0755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084909000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.