Active NPI
Debbie G Wende, OD
- Optometrist
- Brentwood, NY
National Provider Identifier
1295896033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- VUT45791
- Practice address
- 601 Suffolk Ave
Brentwood Vision Center
Brentwood, NY 11717 - Phone
- (631) 273-3335
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | VUT45791 | NY | Primary |
Addresses
Primary practice location
601 Suffolk Ave
Brentwood Vision Center
Brentwood, NY 11717
Mailing address
116 Deforest Rd
Dix Hills, NY 11746
Phone (631) 721-6593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VUT45791 | NY | MD | Optometrist |
| 004579 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1295896033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 DEFOREST RD",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "11746",
"telephone_number": "631-721-6593",
"fax_number": "631-493-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 SUFFOLK AVE",
"address_2": "BRENTWOOD VISION CENTER",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "11717",
"telephone_number": "631-273-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDE",
"first_name": "DEBBIE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "VUT45791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.