Individual provider Active NPI

William John Mohan, O.D.

  • Optometrist
  • Niagara Falls, NY
National Provider Identifier
1285705293
Registry record updated Mar 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003771-1 Issued in NY
Practice address
1540 Military Rd
Walmart Vision Center
Niagara Falls, NY 14304-4704
Phone
(716) 298-5174
Fax
(716) 298-5176
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003771-1 NY Primary

Addresses

Primary practice location

1540 Military Rd
Walmart Vision Center
Niagara Falls, NY 14304-4704

Mailing address

11071 Howe Rd
Akron, NY 14001-9473
Phone (716) 759-7210

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
I20110525000454 NY Practitioner - Optometry 9133305279 Practice locations: Niagara Falls, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003771-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Associates of Western New York PC Past Accepting new patients

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300579200000",
    "number": "1285705293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11071 HOWE RD",
            "city": "AKRON",
            "state": "NY",
            "postal_code": "140019473",
            "telephone_number": "716-759-7210",
            "fax_number": "716-759-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 MILITARY RD",
            "address_2": "WALMART VISION CENTER",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143044704",
            "telephone_number": "716-298-5174",
            "fax_number": "716-298-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003771-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.