NPIMap

Organization Active NPI

Triad Eye Institute PLLC

  • Ophthalmology Physician
  • Tulsa, OK
National Provider Identifier
1184010837
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TRIAD EYE INSTITUTE PLLC
Practice address
6827 S Memorial Dr
Tulsa, OK 74133-2126
Phone
(918) 252-2020
Fax
(918) 307-1983
NPI assigned
Apr 9, 2015
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Ryan Patrick Conley, DO
Title
Medical Director
Phone
(918) 252-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

6827 S Memorial Dr
Tulsa, OK 74133-2126

Mailing address

6140 S Memorial Dr
Tulsa, OK 74133-1933
Phone (918) 994-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

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
This NPI is an additional NPI on the enrollment
Practice locations: Tulsa, OK; Pryor, OK; McAlester, OK; Grove, OK; Claremore, OK; Bartlesville, OK; Muskogee, OK

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2143600Triad Eye Institute Aesthetics & Laser Center6827 S Memorial, Tulsa, OK 74133Certificate of waiverFeb 1, 2028

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 of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1184010837",
    "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": "918-994-7818",
            "fax_number": "918-940-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6827 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741332126",
            "telephone_number": "918-252-2020",
            "fax_number": "918-307-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD EYE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "918-252-2020",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.