David W Wolosin, ABOC, NCLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Practice address

175 N Stephanie St Ste 130
Henderson, NV 89074-8996

Phone

(702) 564-3678

Fax

(702) 564-7552

NPI assigned

Mar 6, 2021

Sex

Male

Sole proprietor

Yes

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 NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Custom Eyes, LLC

  • Eyewear Supplier
  • Henderson, NV
  • NPI 1386820421
  Medicare reassignment NPD Authorized official
• Henderson Family Eyecare

  • Optometrist
  • Henderson, NV
  • NPI 1295392835
  NPD

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1497340947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N STEPHANIE ST STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748996",
            "telephone_number": "702-564-3678",
            "fax_number": "702-564-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N STEPHANIE ST STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748996",
            "telephone_number": "702-564-3678",
            "fax_number": "702-564-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOSIN",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "ABOC, NCLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Wolfe, RN, BSN, IBCLC
• Jared Michael Wolff
• David Jacob Wolfgramm
• Kayla Wolfson
• Ben Wolkenhauer, PT, DPT
• Georgia Ann Wolske, MFT
• Deborah Womack
• Womens Wellness OBGYN LLC
• Angela Wonders
• Aja Wong

• Optician in Henderson, NV
• Providers in Henderson, NV by specialty
• Optician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.