Jesse James Wald, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3103 Issued in OK

Practice address

212 S Main St
Hobart, OK 73651-3628

Phone

(580) 726-3301

Fax

(580) 726-3302

NPI assigned

Aug 4, 2020

Last updated

Aug 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wald Eyecare LLCGroup PAC ID 5496111478, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wald Eyecare LLC

  • Optometrist
  • Hobart, OK
  • NPI 1427745165
  Medicare reassignment Care Compare group NPD Authorized official
• Dwight C Shreck OD

  • Optometrist
  • Weatherford, OK
  • NPI 1891935888
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1982214045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S MAIN ST",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736513628",
            "telephone_number": "580-726-3301",
            "fax_number": "580-726-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S MAIN ST",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736513628",
            "telephone_number": "580-726-3301",
            "fax_number": "580-726-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N Washington St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "OK",
            "postal_code": "730965700",
            "country_code": "US",
            "telephone_number": "580-774-2020",
            "fax_number": "580-736-3302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALD",
        "first_name": "JESSE",
        "middle_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Truett Guthrie (Boothe Drug Store)
• Variety Care, Inc. (Variety Care Hobart)
• Lupe Nicholas Vidaurri, M.ED. SOCIAL SCIENCE
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-0607)
• Wald Eyecare LLC
• Bariah Jade Watson
• Ronda Janette Weaver, L.P.C.
• Linda Sue Wright, LPC, MS
• Yco , Inc (YouthCare of Oklahoma)

• Optometrist in Hobart, OK
• Providers in Hobart, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.