Active NPI
David Robert Kolker, O.D.
- Optometrist
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1110
- Practice address
- 11711 S Hudson PL
Tulsa, OK 74137-8530 - Phone
- (918) 298-4969
- Fax
- (918) 298-4969
- NPI assigned
- Sep 13, 2006
- Last updated
- Nov 30, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1110 | OK | Primary |
Addresses
Primary practice location
11711 S Hudson PL
Tulsa, OK 74137-8530
Mailing address
11711 S Hudson PL
Tulsa, OK 74137-8530
Phone (918) 298-4969
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100765700A | Medicaid | OK |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
119 N 6TH St
Okeene, OK 73763-9135
Phone (918) 381-9363
12109 S 83Rd E Ave
Apt 108
Bixby, OK 74008-3326
Phone (918) 298-4969
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.82 of 100
- Quality
- 79.64
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1110 | OK | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRK Vision Group PLLC | Optometrist | Current | Accepting new patients |
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Andrea B Dudley OD, Inc PC | Optometrist | Past | Accepting new patients |
| Kolker Vision Care | Optometrist | Past | Accepting new patients |
Locations
1709 S Main St
Broken Arrow, OK 74012
Phone (918) 251-2626
801 Highway 48
Holdenville, OK 74848
Phone (405) 379-6671
1425 E Lincoln Rd
Ste A1
Idabel, OK 74745
Phone (580) 286-6000
301 E Dale St
Norman, OK 73069
Phone (405) 217-4786
11063D S Memorial Dr
Unit 515
Tulsa, OK 74133
Phone (918) 398-4969
111 S Lewis Ave
Tulsa, OK 74104
Phone (918) 582-2020
4520 S Harvard Ave
Ste 135
Tulsa, OK 74135
Phone (918) 745-9662
8215 S Mingo Rd
Ste 100
Tulsa, OK 74133
Phone (918) 252-7432
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Interoperability endpoints
- dkolker@direct.revolutionehr.com
Organizations & group practices 7
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.
-
- Optometrist
- Tulsa, OK
- NPI 1043583545
-
- Optometrist
- Broken Arrow, OK
- NPI 1861968992
-
- Optometrist
- Tulsa, OK
- NPI 1700911542
-
- Optometrist
- Oklahoma City, OK
- NPI 1679440762
-
- Optometrist
- Tulsa, OK
- NPI 1235267394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259539200000",
"number": "1073618211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11711 S HUDSON PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741378530",
"telephone_number": "918-298-4969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11711 S HUDSON PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741378530",
"telephone_number": "918-298-4969",
"fax_number": "918-298-4969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLKER",
"first_name": "DAVID",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2009-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "1110",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100765700A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.