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

Last updated

Sep 18, 2019By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• ML Optometry Inc

  dba Menifee Lakes Optometry

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

  dba Lenscrafters #611

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

  dba Lenscrafters #E895

  • 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.