Individual provider Active NPI

Adam Michael Walter, OD

  • Optometrist
  • Omaha, NE
National Provider Identifier
1528065455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1247 Issued in NE
Practice address
6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone
(402) 572-2020
Fax
(402) 572-2150
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3958 FL
Optometrist 152W00000X 1247 NE Primary
Optometrist 152W00000X 02336 IA

Addresses

Primary practice location

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746

Mailing address

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone (402) 572-2020

Other identifiers 2

IdentifierTypeStateIssuer
37083OtherNEBCBS
P00274869OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20060103000479 NE Practitioner - Optometry 4284656307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9973 S 168TH Ave
Omaha, NE 68136-4232
Phone (402) 505-9006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3958FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
J and a Walter LLC Optometrist CurrentSince Jun 15, 2019 Accepting new patients

Locations

9973 S 168th Ave
Omaha, NE 68136
Phone (281) 465-9505

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528065455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3958",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1247",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37083",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00274869",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.