Individual provider Active NPI

Cameron Michael Sikes, OD

  • Optometrist
  • Kingfisher, OK
National Provider Identifier
1104349844
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2952 Issued in OK
Practice address
922 S Main St
Kingfisher, OK 73750-4400
Phone
(405) 375-3128
Fax
(405) 375-3134
NPI assigned
Jul 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2952 OK Primary

Addresses

Primary practice location

922 S Main St
Kingfisher, OK 73750-4400

Mailing address

922 S Main St
Kingfisher, OK 73750-4400
Phone (405) 375-3128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171002003505 TX Practitioner - Optometry 2466727433 Reassigns benefits to 1 organization
I20220113002217 OK Practitioner - Optometry 2466727433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

922 S Main St
Kingfisher, OK 73750-4400
Phone (405) 375-3128

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2952OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gerald W. McMullin, O.D., Inc. Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Kingfisher Family Eyecare Optometrist CurrentSince Dec 29, 2021 Accepting new patients
Citizen Potawatomi Nation CurrentSince Aug 22, 2017 Accepting new patients
Citizen Potawatomi Nation CurrentSince Aug 22, 2017 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients

Locations

922 S Main St
Kingfisher, OK 73750
Phone (405) 375-3128

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 5

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1104349844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 S MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737504400",
            "telephone_number": "405-375-3128",
            "fax_number": "405-375-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 S MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737504400",
            "telephone_number": "405-375-3128",
            "fax_number": "405-375-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKES",
        "first_name": "CAMERON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfisher, OK

Sources for this page

Verify at the official NPI Registry.