NPIMap

Organization Active NPI

Dr. Alissa Wald and Associates Optometry, Inc.

  • Optometrist
  • Costa Mesa, CA
National Provider Identifier
1851574958
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT9377 Issued in CA
Legal business name
DR. ALISSA WALD AND ASSOCIATES OPTOMETRY, INC.
Doing business as
OC Eye Designs Optometry
Practice address
1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814
Phone
(714) 545-9162
Fax
(714) 241-1345
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

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

Authorized official

Name
Dr. Alissa Wald, O.D.NPI 1720132251
Title
Owner
Phone
(714) 545-9162

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT9377 CA Primary

Addresses

Primary practice location

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

Mailing address

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814
Phone (714) 545-9162

Other names 1

  • OC Eye Designs Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040228000531 CA Part B Supplier - Clinic/Group Practice 3779470380 Receives reassigned benefits from 12 practitioners
Practice locations: Costa Mesa, CA

National Provider Directory

National Provider Directory

Locations

1545 Adams Ave
Costa Mesa, CA 92626

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582329600000",
    "number": "1851574958",
    "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": {
        "organization_name": "DR. ALISSA WALD AND ASSOCIATES OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A",
        "authorized_official_last_name": "WALD",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-545-9162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Eye Designs Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.