NPIMap

Organization Active NPI

Triad Eye Institute PLLC

  • Ophthalmology Physician
  • Tulsa, OK
National Provider Identifier
1093743213
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
731288036 Issued in OK
Legal business name
TRIAD EYE INSTITUTE PLLC
Practice address
6140 S Memorial Dr
Tulsa, OK 74133-1933
Phone
(918) 252-2020
Fax
(918) 307-1983
NPI assigned
Jun 28, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Dr. Ryan P Conley, D.O.NPI 1417016312
Title
Owner
Phone
(918) 252-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 731288036 OK
Ophthalmology Physician 207W00000X 731288036 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
490004258OtherOKRAILROAD MEDICARE
490000830OtherOKRAILROAD MEDICARE
CO5028OtherOKRAILROAD MEDICARE

Other names 1

  • Triad Eye Medical Clinic & cataract Institute Co Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140918000152 OK Part B Supplier - Clinic/Group Practice 6507083557 Receives reassigned benefits from 32 practitioners
1 other NPI on this enrollment
Practice locations: Tulsa, OK; Pryor, OK; McAlester, OK; Grove, OK; Claremore, OK; Bartlesville, OK; Muskogee, OK
O20241004000419 AR Part B Supplier - Clinic/Group Practice 6507083557 Receives reassigned benefits from 8 practitioners
Practice locations: Bentonville, AR; Fayetteville, AR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Triad Eye Institute PLLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

1102 NW Lowes Ave
Ste 6
Bentonville, AR 72712
Phone (479) 442-8653

63223 E 290 Rd
Grove, OK 74344
Phone (918) 786-3937

1001 E Wyandotte Ave
McAlester, OK 74501
Phone (918) 302-9232

8023 E 63rd Pl
Ste 500
Tulsa, OK 74133
Phone (918) 252-2020

Interoperability endpoints

  • Direct secure messaging: aavilez@triadeye.intellechartdirect.net
  • Direct secure messaging: ahromas@triadeye.intellechartdirect.net
  • Direct secure messaging: avenizelos@triadeye.intellechartdirect.net
  • Direct secure messaging: cyang@triadeye.intellechartdirect.net
  • Direct secure messaging: ebaggs@triadeye.intellechartdirect.net
  • Direct secure messaging: eholden@triadeye.intellechartdirect.net
  • Direct secure messaging: jbryant@triadeye.intellechartdirect.net
  • Direct secure messaging: jguffey@triadeye.intellechartdirect.net
  • Direct secure messaging: jparschauer@triadeye.intellechartdirect.net
  • Direct secure messaging: kpiwonka@triadeye.intellechartdirect.net
  • Direct secure messaging: ksantillan@triadeye.intellechartdirect.net
  • Direct secure messaging: lfreisberg@triadeye.intellechartdirect.net
  • Direct secure messaging: mclary@triadeye.intellechartdirect.net
  • Direct secure messaging: mgill@triadeye.intellechartdirect.net
  • Direct secure messaging: mkhattab@triadeye.intellechartdirect.net
  • Direct secure messaging: mmcfarland@triadeye.intellechartdirect.net
  • Direct secure messaging: mmequio@triadeye.intellechartdirect.net
  • Direct secure messaging: pwojcik@triadeye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1093743213",
    "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": "6140 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331933",
            "telephone_number": "918-252-2020",
            "fax_number": "918-307-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD EYE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-252-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "731288036",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "731288036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004258",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490000830",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CO5028",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triad Eye Medical Clinic & cataract Institute Co Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.