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Active NPI 1073545059 Individual Practitioner Male Practitioner

Dr. Larry B Wallace , OD

Optometrist - Vision Therapy • Ithaca, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Larry Wallace, OD is a certified Optometrist - Vision Therapy practicing in Ithaca, NY. With approximately 53 years of clinical experience since graduating from New England College Of Optometry in 1973, Dr. Wallace delivers high-quality medical care to the local community at 322 N AURORA ST.

Dr. Wallace is affiliated with Whole Picture Health And Vision Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient problem focused exam of visual system, exam to measure eye deviation and range of motion, exam of visual field with intermediate testing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

322 N Aurora St

Ithaca, NY 148504202

Telephone 6072774749
Fax 6072775216
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

New England College Of Optometry

Graduation Year

1973

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist - Vision Therapy in Ithaca, NY

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
53 Yrs +22.0 yrs vs City Avg
City Avg: 31.0 Yrs
State Avg: 26.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Ithaca, NY (52 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
29.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (53 Years) 53 Yrs
Ithaca Specialty Average (31.0 Years) 31.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92012 Established patient problem focused exam of visual system
51 28 $110.00 $84.37
92060 Exam to measure eye deviation and range of motion
41 27 $80.00 $60.41
92082 Exam of visual field with intermediate testing
30 17 $85.00 $43.39
99213 Established patient office or other outpatient visit, typically 15 minutes
25 14 $115.00 $86.21
92014 Established patient complete exam of visual system
23 23 $165.00 $119.39

Medical Specialties & State Licenses

Optometrist - Vision Therapy Primary Specialty

NUCC Taxonomy Code: 152WV0400X

State License NY VUT003212

Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.

Optometrist - Low Vision Rehabilitation

NUCC Taxonomy Code: 152WL0500X

State License NY VUT003212

Optometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and recommend other vision rehabilitation services.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Ny State License
T003212-1 (NY)

Hospital & Practice Group Affiliations

Whole Picture Health And Vision Llc

322 N Aurora St, Ithaca, NY 148504202

Phone: 6072774749

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Tanya Bloom , OD

Optometrist - Vision Therapy

NPI 1144750035

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 06, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location October 06, 2010

Registered at 322 N AURORA ST, ITHACA, NY 148504202 (Tel: 6072774749)

📍
Updated Business Mailing Address October 06, 2010

Registered at 322 N. AURORA ST., ITHACA, NY 14850 (Tel: 6072774749)

👤
Provider Name / Credentials Updated October 06, 2010

Recorded as LARRY WALLACE, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2010

Optometrist (License #VUT003212 in NY)

🟢
Initial NPI Registration & Enumeration July 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073545059
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 07, 2006
Last Update: October 06, 2010
Sole Proprietor: Yes

Mailing Address

322 N. Aurora St.

Ithaca, NY 14850

Phone: 6072774749

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.