Austin B Byrum, OD
Individual provider Active NPI Optometrist · Stigler, OK
NPI 1104303908 · NPPES record last updated Jul 24, 2018
Key facts
- NPI
- 1104303908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2966 (OK)
- Practice address
- 1505 E Main St
Stigler, OK 74462-2913 - Phone
- (918) 967-3368
- Fax
- (918) 967-4582
- NPI assigned
- Jul 24, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stigler Health and Wellness Center Inc
Practice addresses (Care Compare)
1505 E Main St
Stigler, OK 74462-2914
Phone (800) 640-9741
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180905000128 | OK | Practitioner - Optometry | 5698025120 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2966 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stigler Health and Wellness Center Inc | Current |
Accepting new patients |
Locations
1630 S Kerr Blvd
Sallisaw, OK 74955
Phone (918) 790-2653
1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741
Interoperability endpoints
- abyrum728017@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2966 | OK | Yes |
Addresses
Primary practice location
1505 E Main St
Stigler, OK 74462-2913
Mailing address
PO Box 179
Stigler, OK 74462-0179
Phone (918) 967-3368
Other providers in Stigler, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.