Individual provider Active NPI

Jamie A. Bennett, O.D.

  • Optometrist
  • Bartlesville, OK
National Provider Identifier
1083800080
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1189 Issued in OK
Practice address
401 E Silas St
Bartlesville, OK 74003-3611
Phone
(918) 336-4068
NPI assigned
Sep 24, 2007
Last updated
Apr 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1189 OK Primary

Addresses

Primary practice location

401 E Silas St
Bartlesville, OK 74003-3611

Mailing address

401 E Silas St
Bartlesville, OK 74003-3611
Phone (918) 336-4068

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
I20120418000641 OK Practitioner - Optometry 4789743675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 E Silas St
Bartlesville, OK 74003-3611
Phone (918) 336-4068

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1189OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamie Archer Bennett, OD,PC Optometrist CurrentSince Jul 16, 2003 Accepting new patients

Locations

401 E Silas St
Bartlesville, OK 74003
Phone (918) 336-4068

Organizations & group practices 1

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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1083800080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E SILAS ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033611",
            "telephone_number": "918-336-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SILAS ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033611",
            "telephone_number": "918-336-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JAMIE",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.