Matthew Walsh, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

OPC4575 Issued in FL

Practice address

3200 S University Dr
Ziff Building, 2ND Floor
Davie, FL 33328-2018

Phone

(954) 262-4200

NPI assigned

Jul 27, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)
• Nova Southeastern University, Inc

  • Optometrist
  • Davie, FL
  • NPI 1588802169
  NPD (past)

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1669786166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 SE 35TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339044779",
            "telephone_number": "239-542-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "ZIFF BUILDING, 2ND FLOOR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007630",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "TUV007630",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC4575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Ann Wallace
• Gerald William Wallach, D.D.S.
• Charlotte Victoria Walsh
• Erin Marie Walsh, MS
• Maricel Walsh
• Charlotte Mae Walter
• Iliamaris Rivera Walter, LMFT
• Kadey Walters, FNP
• Nadia S Walters
• Si Wang, O.D

• Vision Therapy Optometrist in Davie, FL
• Providers in Davie, FL by specialty
• Vision Therapy Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.