Individual provider Active NPI

Kimberly Wadas

  • Optometrist
  • Whitesboro, NY
National Provider Identifier
1992234892
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008569 Issued in NY
Practice address
38 Roosevelt Dr
Whitesboro, NY 13492-1550
Phone
(315) 736-3217
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008569 NY Primary

Addresses

Primary practice location

38 Roosevelt Dr
Whitesboro, NY 13492-1550

Mailing address

408 Main St
New York Mills, NY 13417-1239

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180125001517 NY Practitioner - Optometry 1951660687 Reassigns benefits to 3 organizations
Practice locations: Whitesboro, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wadas Optometric Group, PCGroup PAC ID 0042546368, 7 clinicians
Central Association for the Blind IncGroup PAC ID 9234024746, 5 clinicians

Practice addresses (Care Compare)

38 Roosevelt Dr
Whitesboro, NY 13492-1550
Phone (315) 736-3217

507 Kent St
Utica, NY 13501-2317
Phone (315) 797-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008569NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sightrite Inc Optometrist CurrentSince Apr 1, 2022 Accepting new patients
Central Association for the Blind, Inc. CurrentSince Nov 1, 2018 Accepting new patients
Wadas Optometric Group, PC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Central Association for the Blind and Visually Impaired PastSince Nov 1, 2018 Accepting new patients

Locations

8010 State Route 12
Ste 1
Barneveld, NY 13304
Phone (315) 896-3900

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

394 E State St
Herkimer, NY 13350
Phone (315) 866-3751

6050 Court Street Rd
Syracuse, NY 13206
Phone (315) 797-2233

507 Kent St
Utica, NY 13501
Phone (315) 797-2233

134 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 321-3850

38 Roosevelt Dr
Whitesboro, NY 13492
Phone (315) 404-8275

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1992234892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 MAIN ST",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134171239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 ROOSEVELT DR",
            "city": "WHITESBORO",
            "state": "NY",
            "postal_code": "134921550",
            "telephone_number": "315-736-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADAS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesboro, NY

Sources for this page

Verify at the official NPI Registry.