Active NPI
Thomas Joseph Wells, O.D.
- Optometrist
- Liverpool, NY
National Provider Identifier
1568479012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV 2862-1
- Practice address
- 205 1St St
Liverpool, NY 13088-5109 - Phone
- (315) 457-7968
- Fax
- (315) 457-8017
- NPI assigned
- Aug 1, 2006
- Last updated
- Apr 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | TUV 2862-1 | NY | Primary |
Addresses
Primary practice location
205 1St St
Liverpool, NY 13088-5109
Mailing address
205 1St St
Liverpool, NY 13088-5109
Phone (315) 457-7968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110107000598 | NY | Practitioner - Optometry | 8123232733 | Practice locations: Liverpool, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV 2862-1 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1568479012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 1ST ST",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130885109",
"telephone_number": "315-457-7968",
"fax_number": "315-457-8017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 1ST ST",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130885109",
"telephone_number": "315-457-7968",
"fax_number": "315-457-8017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV 2862-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.