Individual provider Active NPI

Brandon Knox Ross, O.D.

  • Optometrist
  • Lawton, OK
National Provider Identifier
1003194861
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2708 Issued in OK
Practice address
4250 NW Cache Rd.
Lawton, OK 73505-4315
Phone
(580) 353-5090
Fax
(580) 353-5105
NPI assigned
Jul 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2708 OK Primary

Addresses

Primary practice location

4250 NW Cache Rd.
Lawton, OK 73505-4315

Mailing address

4250 NW Cache Rd.
Lawton, OK 73505-4315
Phone (580) 353-5090

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
I20111102000244 OK Practitioner - Optometry 8224201520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Health Associates P.L.L.C.Group PAC ID 0840294120, 7 clinicians

Practice addresses (Care Compare)

4250 NW Cache Rd
Complete Eye Care
Lawton, OK 73505-3606
Phone (580) 248-0061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2708OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Associates, P.L.L.C. Optometrist CurrentSince Jan 1, 2015 Accepting new patients

Locations

4250 NW Cache Rd
Lawton, OK 73505
Phone (580) 248-0061

918 NW 32nd St
Newcastle, OK 73065
Phone (405) 387-4011

2946 NW 32nd St
Ste A
Newcastle, OK 73065
Phone (405) 387-4884

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1003194861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 NW CACHE RD.",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054315",
            "telephone_number": "580-353-5090",
            "fax_number": "580-353-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 NW CACHE RD.",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054315",
            "telephone_number": "580-353-5090",
            "fax_number": "580-353-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "BRANDON",
        "middle_name": "KNOX",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-28",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.