Individual provider Active NPI

Theodore J Wadas, OD

  • Optometrist
  • New York Mills, NY
National Provider Identifier
1285700195
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV48601 Issued in NY
Practice address
408 Main St
New York Mills, NY 13417-1239
Phone
(315) 736-3217
Fax
(315) 736-3217
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV48601 NY Primary

Addresses

Primary practice location

408 Main St
New York Mills, NY 13417-1239

Mailing address

38 Roosevelt Dr
Whitesboro, NY 13492-1550
Phone (315) 736-3217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090423000281 NY Practitioner - Optometry 6406904838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wadas Optometric Group, PCGroup PAC ID 0042546368, 7 clinicians

Practice addresses (Care Compare)

38 Roosevelt Dr
Whitesboro, NY 13492-1550
Phone (315) 736-3217

Merit-based Incentive Payment System (MIPS)

Final score
15 of 100Reported as individual
Quality
30
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV48601NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wadas Optometric Group, PC Optometrist CurrentSince Jul 1, 2019 Accepting new patients

Locations

8010 State Route 12
Ste 1
Barneveld, NY 13304
Phone (315) 896-3900

2150 Bleecker St
Utica, NY 13501
Phone (315) 798-4800

38 Roosevelt Dr
Whitesboro, NY 13492
Phone (315) 404-8275

Organizations & group practices 1

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1285700195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ROOSEVELT DR",
            "city": "WHITESBORO",
            "state": "NY",
            "postal_code": "134921550",
            "telephone_number": "315-736-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MAIN ST",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134171239",
            "telephone_number": "315-736-3217",
            "fax_number": "315-736-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADAS",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV48601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York Mills, NY

Sources for this page

Verify at the official NPI Registry.