Alissa Sue Wald, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9377TPL Issued in CA

Practice address

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814

Phone

(714) 545-9162

Fax

(714) 241-1345

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Alissa Wald and Associates Optometry IncGroup PAC ID 3779470380, 5 clinicians

Woodbridge Optometry IncGroup PAC ID 6901181510, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr. Alissa Wald and Associates Optometry, Inc.

  • Optometrist
  • Costa Mesa, CA
  • NPI 1851574958
  Medicare reassignment Care Compare group NPD Authorized official
• Woodbridge Optometry, Inc.

  • Optometrist
  • Irvine, CA
  • NPI 1891232096
  Medicare reassignment Care Compare group NPD Authorized official
• Christopher P. Likens & Nancy L. Wilson PTR

  • Optometrist
  • Irvine, CA
  • NPI 1336262377
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1720132251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE",
            "address_2": "SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263814",
            "telephone_number": "714-545-9162",
            "fax_number": "714-241-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE",
            "address_2": "SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263814",
            "telephone_number": "714-545-9162",
            "fax_number": "714-241-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALD",
        "first_name": "ALISSA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9377TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7145459162",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aye Waddy
• Amanda Leigh Wainfan, DC
• Megan Demi Waintal
• Erica Wakefield, BA
• Greyson Myles Walbrink
• Natalie Waldman, MS-CCC, SLP
• Walgreen Co
• Michelle Walker
• Olivia Charlotte Walker
• Walking Shield, Inc.

• Optometrist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.