Individual provider Active NPI

Thomas M Nicholas II, O.D.

  • Optometrist
  • Enid, OK
National Provider Identifier
1184622235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2256 Issued in OK
Practice address
1204 W Willow Rd
Suite a
Enid, OK 73703-2531
Phone
(580) 234-2333
Fax
(580) 234-0820
NPI assigned
Jul 12, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2256 OK Primary

Addresses

Primary practice location

1204 W Willow Rd
Suite a
Enid, OK 73703-2531

Mailing address

1204 W Willow Rd
Suite a
Enid, OK 73703-2531
Phone (580) 234-2333

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
I20101115000068 OK Practitioner - Optometry 9537271770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1204 W Willow Rd
Suite a
Enid, OK 73703-2531
Phone (580) 234-2333

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2256OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Eye Clinic, PLLC Optometrist CurrentSince Aug 15, 2000 Accepting new patients

Locations

1204 W Willow Rd
Ste A
Enid, OK 73703
Phone (580) 234-2333

Organizations & group practices 1

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184622235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 W WILLOW RD",
            "address_2": "SUITE A",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032531",
            "telephone_number": "580-234-2333",
            "fax_number": "580-234-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W WILLOW RD",
            "address_2": "SUITE A",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032531",
            "telephone_number": "580-234-2333",
            "fax_number": "580-234-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.