Active NPI
Wibert Charles Lusk, O.D.
- Optometrist
- Oneonta, NY
National Provider Identifier
1649359522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 002556-1
- Practice address
- 5024 State Highway 23
Walmart Vison Center
Oneonta, NY 13820 - Phone
- (607) 433-4776
- Fax
- (607) 433-4695
- NPI assigned
- Nov 3, 2006
- 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 | 002556-1 | NY | Primary |
Addresses
Primary practice location
5024 State Highway 23
Walmart Vison Center
Oneonta, NY 13820
Mailing address
4 Lakeview Dr N
Cooperstown, NY 13326-3001
Phone (607) 547-8253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002556-1 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649359522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 LAKEVIEW DR N",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133263001",
"telephone_number": "607-547-8253",
"fax_number": "607-547-8253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5024 STATE HIGHWAY 23",
"address_2": "WALMART VISON CENTER",
"city": "ONEONTA",
"state": "NY",
"postal_code": "13820",
"telephone_number": "607-433-4776",
"fax_number": "607-433-4695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSK",
"first_name": "WIBERT",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "002556-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oneonta, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.