Carissa Villaflor Beaudreau, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3055 Issued in OK

Practice address

5600 N Portland Ave
Oklahoma City, OK 73112-2023

Phone

(405) 943-4413

Fax

(405) 942-0115

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oklahoma Eye Surgeons PLLCGroup PAC ID 0840549994, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Oklahoma Eye Surgeons PLLC

  • Ophthalmology Physician
  • Oklahoma City, OK
  • NPI 1033696893
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1154933638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122023",
            "telephone_number": "405-943-4413",
            "fax_number": "405-942-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122023",
            "telephone_number": "405-943-4413",
            "fax_number": "405-942-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDREAU",
        "first_name": "CARISSA",
        "middle_name": "VILLAFLOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dasha A Beatty
• Megan Utz Beatty, M.D.
• Marlene Janeth Beaty, APRN CNP
• Miranda N Beaty
• Paige Jordan Beauclair, SLP-A
• Shantel Ayesha Beaupierre
• Joshua Andrew Beauregard
• Beautifully Connected Pregnancy and Wellness
• Beauty Thru Health Dermatology, P.C.
• Breanna Beaver

• Optometrist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.