Individual provider Active NPI

Joni S Couch, O.D.

  • Optometrist
  • Muskogee, OK
National Provider Identifier
1073592002
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2470 Issued in OK
Practice address
3131 Military Blvd
Muskogee, OK 74401-2290
Phone
(918) 687-6600
Fax
(918) 687-6610
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2470 OK Primary

Addresses

Primary practice location

3131 Military Blvd
Muskogee, OK 74401-2290

Mailing address

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

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
CO5028OtherOKRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrussell@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
I20051228000470 OK Practitioner - Optometry 2860418357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Eye Institute PLLCGroup PAC ID 6507083557, 36 clinicians

Practice addresses (Care Compare)

3131 Military Blvd
Muskogee, OK 74401-2290
Phone (918) 687-6600

Merit-based Incentive Payment System (MIPS)

Final score
99.56 of 100Reported as individual
Quality
99.2
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2470OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Surgery Center LLC Past Accepting new patients
Triad Eye Medical Clinic & Cataract Institute Co Inc Optometrist Past Accepting new patients
Triad Surgery Center, LLC Past Accepting new patients
Triad Surgery Center LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jrussell@triadeye.intellechartdirect.net

Organizations & group practices 5

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073592002",
    "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": "918-307-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 MILITARY BLVD",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012290",
            "telephone_number": "918-687-6600",
            "fax_number": "918-687-6610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741331933",
            "country_code": "US",
            "telephone_number": "918-252-2020",
            "fax_number": "918-307-1983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUCH",
        "first_name": "JONI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2022-07-21",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CO5028",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrussell@triadeye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "3131 Military Blvd",
            "city": "Muskogee",
            "state": "OK",
            "country_code": "US",
            "postal_code": "744012290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.