Individual provider Active NPI

Kanita L. Moser, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1073705471
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2509 Issued in OK
Practice address
500 SW 44TH St
Oklahoma City, OK 73109-3540
Phone
(405) 632-6688
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2509 OK Primary

Addresses

Primary practice location

500 SW 44TH St
Oklahoma City, OK 73109-3540

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

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
I20140321001225 OK Practitioner - Optometry 2668527342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

500 SW 44TH St
Oklahoma City, OK 73109-3540
Phone (405) 632-6688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc CurrentSince Dec 28, 2013 Accepting new patients

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

1025 Straka Ter
Oklahoma City, OK 73139
Phone (405) 629-5281

Interoperability endpoints

  • Direct secure messaging: kmoser376554@direct.ochin.org

Organizations & group practices 2

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1073705471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093540",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "KANITA",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.