Kelly Glass, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2887 Issued in OK

Practice address

2500 W New Orleans St
Broken Arrow, OK 74011-1574

Phone

(918) 893-3769

Fax

(918) 286-8281

NPI assigned

Jul 15, 2014

Last updated

Mar 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Specialty

Optometry

Education

University of Houston - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beatty-JTJV LLCGroup PAC ID 7810426210, 4 clinicians

Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beatty-JTJV LLC

  dba MyEyeDr.

  • Optometrist
  • Sand Springs, OK
  • NPI 1093531766
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Broken Bow, OK
  • NPI 1174089478
  Medicare reassignment Care Compare group NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• David R. Free, O.D. PC

  • Optometrist
  • Tulsa, OK
  • NPI 1598824914
  Medicare reassignment NPD
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  Medicare reassignment NPD
• Tahlequah Family Vision Clinic, PLLC

  dba Tahlequah Family Vision Clinic

  • Optometrist
  • Tahlequah, OK
  • NPI 1033313754
  Medicare reassignment NPD
• Beatty-JTJV LLC

  dba MyEyeDr.

  • Optometrist
  • Claremore, OK
  • NPI 1063238731
  NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Broken Arrow, OK
  • NPI 1760152805
  NPD

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1023425675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W NEW ORLEANS ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740111574",
            "telephone_number": "918-893-3769",
            "fax_number": "918-286-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Loran Gilbert, LPC LADC
• Carly Gillman, DPT
• Gilstrap Services LLC (Floss Boss Pediatric Dentistry)
• Tammy Marie Gipson, RDN
• David Bryan Glanz
• Global Administration Incorporated
• Dewanna Goff
• Eric T Golbek, DDS
• Julia Allyson Gold
• Golden Medical Services

• Optometrist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.