Individual provider Active NPI

Wade A. Walls, OD

  • Optometrist
  • Miami, OK
National Provider Identifier
1992741250
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK 2235 Issued in OK
Practice address
2222 N Main St
Miami, OK 74354-1619
Phone
(918) 542-1929
Fax
(918) 542-7796
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK 2235 OK Primary

Addresses

Primary practice location

2222 N Main St
Miami, OK 74354-1619

Mailing address

2222 N Main St
Miami, OK 74354-1619
Phone (918) 542-1929

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100702000426 OK Practitioner - Optometry 0648301846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of Miami IncGroup PAC ID 1658402854, 3 clinicians

Practice addresses (Care Compare)

2222 N Main St
Miami, OK 74354-1619
Phone (918) 542-1929

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2235OKMDProfessional Counselor
OK 2235OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Miami, Inc. Optometrist CurrentSince Dec 22, 1997 Accepting new patients

Locations

2222 N Main St
Miami, OK 74354
Phone (918) 540-1929

Interoperability endpoints

  • Direct secure messaging: drwalls@eyeassocmiami.eyefinity-direct.com

Organizations & group practices 1

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1992741250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N MAIN ST",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541619",
            "telephone_number": "918-542-1929",
            "fax_number": "918-542-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N MAIN ST",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541619",
            "telephone_number": "918-542-1929",
            "fax_number": "918-542-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "WADE",
        "middle_name": "A.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK 2235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.