Individual provider Active NPI

Brett M Enyart, O.D.

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1043216146
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2301 Issued in OK
Practice address
6140 S Memorial Dr
Tulsa, OK 74133-1933
Phone
(918) 252-2020
Fax
(918) 252-7466
NPI assigned
Jun 23, 2005
Last updated
May 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2301 OK Primary

Addresses

Primary practice location

6140 S Memorial Dr
Tulsa, OK 74133-1933

Mailing address

6140 S Memorial Dr
Tulsa, OK 74133-1933
Phone (918) 252-2020

Other identifiers 3

IdentifierTypeStateIssuer
410045748OtherOKMEDICARE ID
CO5028OtherOKMEDICARE ID
100763330AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benyart@triadeye.intellechartdirect.net

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
I20100611000647 OK Practitioner - Optometry 5890825145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brett Enyart OD PLLCGroup PAC ID 9537310404, 2 clinicians
Triad Eye Institute PLLCGroup PAC ID 6507083557, 36 clinicians

Practice addresses (Care Compare)

5335 W Rogers Blvd B
Skiatook, OK 74070-5285
Phone (918) 396-4440

8023 E 63Rd PL
Suite 500
Tulsa, OK 74133-1209
Phone (918) 252-2020

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as individual
Quality
92.76
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301OKMDSpeech-Language Pathologist
7OKMDRadiology Practitioner Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brett Enyart, OD, PLLC Optometrist CurrentSince Oct 15, 2012 Accepting new patients
Triad Surgery Center, LLC Past Accepting new patients
Triad Surgery Center LLC Past Accepting new patients
Triad Surgery Center LLC Past Accepting new patients
Advantage Eyecare, P.C. Optometrist PastSince Oct 15, 2012 Accepting new patients

Locations

5335 W Rogers Blvd
Skiatook, OK 74070
Phone (918) 396-4440

5335 W Rogers Blvd
Ste B
Skiatook, OK 74070
Phone (918) 396-4440

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1043216146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331933",
            "telephone_number": "918-252-2020",
            "fax_number": "918-252-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331933",
            "telephone_number": "918-252-2020",
            "fax_number": "918-252-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENYART",
        "first_name": "BRETT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "410045748",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CO5028",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100763330A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benyart@triadeye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "6140 S Memorial Dr",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741331933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.