Individual provider Active NPI

Stacy G Presley, OD

  • Optometrist
  • Ada, OK
National Provider Identifier
1164432167
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2431 Issued in OK
Practice address
1433 Arlington St
Ada, OK 74820-2636
Phone
(580) 332-5606
Fax
(580) 332-3946
NPI assigned
Aug 9, 2006
Last updated
Feb 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2431 OK Primary

Addresses

Primary practice location

1433 Arlington St
Ada, OK 74820-2636

Mailing address

1433 Arlington St
Ada, OK 74820-2636
Phone (580) 332-5606

Other identifiers 2

IdentifierTypeStateIssuer
200078050AMedicaidOK
201496058-001OtherOKBLUE CROSS BLUE SHIELD

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
I20040813000750 OK Practitioner - Optometry 9830162379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1433 Arlington St
Ada, OK 74820-2636
Phone (580) 332-5606

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2431OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stacy G Presley OD PLLC Optometrist CurrentSince Apr 30, 2003 Accepting new patients
Dr Charles W Gurley OD PC Optometrist Past Accepting new patients

Locations

1433 Arlington St
Ada, OK 74820
Phone (580) 332-5606

216 W 12th St
Ada, OK 74820
Phone (580) 332-5606

Interoperability endpoints

  • Direct secure messaging: spresley@advancedeye.eyefinity-direct.com

Organizations & group practices 2

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1164432167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202636",
            "telephone_number": "580-332-5606",
            "fax_number": "580-332-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202636",
            "telephone_number": "580-332-5606",
            "fax_number": "580-332-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "STACY",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200078050A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "201496058-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.