Nicholas Roy Walworth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13632 TPA Issued in CA

Practice address

30141 Antelope Rd Ste G
Menifee, CA 92584-8066

Phone

(951) 679-6910

NPI assigned

Dec 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

New England College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• ML Optometry Inc

  • Optometrist
  • Menifee, CA
  • NPI 1710431416
  Medicare reassignment NPD Authorized official
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1295980423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30141 ANTELOPE RD STE G",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848066",
            "telephone_number": "951-679-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30141 ANTELOPE RD STE G",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848066",
            "telephone_number": "951-679-6910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30145 Antelope Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "925848065",
            "country_code": "US",
            "telephone_number": "951-679-6910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALWORTH",
        "first_name": "NICHOLAS",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-02",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13632 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason R Walker
• Laodecia Walker, REGISTERED NURSE
• Natalie Walker
• Samuel Robert Wallace-Douglas
• Christopher Walters, DDS
• Kera Washburn, CCC-SLP
• Natalie Watts, LMFT
• We Care Medical Transportation LLC
• Diane Weidemann, PTA
• Michele Lynn Welker, NP

• Optometrist in Menifee, CA
• Providers in Menifee, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.