David Wallach, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004825 Issued in NY

Practice address

16820 Jamaica Ave
Jamaica, NY 11432-5216

Phone

(718) 739-5454

Fax

(718) 526-1818

NPI assigned

May 10, 2007

Sex

Male

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 NY

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

State University of New York - State College Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Island Vision Optometry PCGroup PAC ID 8729384847, 2 clinicians

Practice addresses (Care Compare)

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.

• Long Island Vision Optometry P.C.

  • Optometrist
  • Bay Shore, NY
  • NPI 1548635352
  Medicare reassignment Care Compare group NPD
• Jamaica Eye Care Center LLC

  • Optometrist
  • Jamaica, NY
  • NPI 1912466707
  Medicare reassignment NPD
• Main Optical LLC

  dba Main Optical

  • Optician
  • Flushing, NY
  • NPI 1003176603
  Medicare reassignment NPD

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972717544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 173RD ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113653432",
            "telephone_number": "718-739-5454",
            "fax_number": "718-526-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16820 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325216",
            "telephone_number": "718-739-5454",
            "fax_number": "718-526-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01178821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shereka Kayann Walker
• Sherene Walker, LPN
• Travis Walker, FNP-BC
• Vesta Walker, LCSW
• Kiera Wallace Robinson, MD, MPH
• Sheena Andree Wallerson
• Danny Walls
• Taylor M Walsh, PA
• Helen Walter, NP
• Phylicia Walters

• Optometrist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Optometrist in New York

• 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.
• 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.