WALTER MARIO BECKFORD, O.D. — NPI 1174551576 (Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) in RANDOLPH, NJ)

CMS-1500 Box 24J / 33a • NPI

1174551576

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

152WP0200X (CMS 41)

Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)

Box 32 Service Location & ZIP+4

124 RTE 10, RANDOLPH, NJ, 07869-2415

✓ 9-Digit EDI 837 ZIP+4 (07869-2415)

Practice Phone & Referral Fax

(973) 366-1345

Fax: (973) 366-1347

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174551576 (WALTER MARIO BECKFORD, O.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174551576` (NPI-1 Individual Practitioner)
Provider / Legal Name	WALTER MARIO BECKFORD, O.D.
Plain-English Specialty	Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: `152WP0200X` (Optometrist, Pediatrics)
Certifying / Licensing Body	American Board of Pediatrics (ABP)
Practice Location Address	124 RTE 10, RANDOLPH, NJ, 07869-2415
Practice Telephone / Fax	Tel: (973) 366-1345 \| Fax: (973) 366-1347
Administrative Mailing Address	88 E MAIN ST, MENDHAM, NJ, 07945-1832
Enumeration & Last Sync	Enumerated: 2006-06-28 \| CMS Record Updated: 2012-10-29

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

124 RTE 10, RANDOLPH, NJ, 07869-2415

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Plain-English Taxonomy & CMS Crosswalk (152WP0200X)

What Does Taxonomy Code 152WP0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152WP0200X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 41 (Optometry)
Certifying / Accrediting Authority: American Board of Pediatrics (ABP)
Clinical Scope: Newborn jaundice screening, routine childhood vaccinations, developmental milestones, pediatric fevers, ear infections, asthma, or acute gastroenteritis.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (WALTER MARIO BECKFORD, O.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
Pediatric Asthma Nebulization & Spirometry Evaluation

Common Therapeutic Classes:

Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`152WC0802X` — Optometrist, Corneal and Contact Management Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management	State: NJ \| License: `270A00505200` \| Primary: Secondary
`152WP0200X` — Optometrist, Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: NJ \| License: `27OA00505200` \| Primary: Yes (Primary)
`152WX0102X` — Optometrist, Occupational Vision Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Occupational Vision	State: NJ \| License: `NJOA00505200` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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WALTER MARIO BECKFORD, O.D. (NPI #1174551576)