Individual provider Active NPI

John David Macarty, O.D.

  • Optometrist
  • Pawhuska, OK
National Provider Identifier
1184712069
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2045 Issued in OK
Practice address
715 Grandview Ave
Pawhuska, OK 74056-3201
Phone
(918) 287-9300
Fax
(918) 287-6138
NPI assigned
Oct 10, 2006
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2045 OK Primary

Addresses

Primary practice location

715 Grandview Ave
Pawhuska, OK 74056-3201

Mailing address

902 E Lincoln Rd
Idabel, OK 74745-7337
Phone (580) 286-2600

Other practice location 1

902 E Lincoln Rd
Idabel, OK 74745-7337
Phone (580) 286-2600

Other identifiers 1

IdentifierTypeStateIssuer
100760170AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120208000999 TX Practitioner - Optometry 5496815151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osage Nation Si-Si a-Pe-TxaGroup PAC ID 2769847912, 13 clinicians

Practice addresses (Care Compare)

715 Grandview Ave
Pawhuska, OK 74056-3201
Phone (918) 287-9335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Osage Nation Si-Si a-Pe-Txa CurrentSince Feb 3, 2023 Accepting new patients
Osage Nation Si-Si a-Pe-Txa Past Accepting new patients

Locations

715 Grandview Ave
Pawhuska, OK 74056
Phone (918) 287-4491

316 E Main St
Pawhuska, OK 74056
Phone (918) 287-9300

Interoperability endpoints

  • Direct secure messaging: jmacarty27079@muscogeecreeknation.direct-ci.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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1184712069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 GRANDVIEW AVE",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740563201",
            "telephone_number": "918-287-9300",
            "fax_number": "918-287-6138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 E Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Idabel",
            "state": "OK",
            "postal_code": "747457337",
            "country_code": "US",
            "telephone_number": "580-286-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACARTY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100760170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawhuska, OK

Sources for this page

Verify at the official NPI Registry.