Organization Active NPI

Partin Eyecare PC

  • Optometrist
  • Mustang, OK
National Provider Identifier
1194377168
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PARTIN EYECARE PC
Practice address
1100 N Mustang Rd
Mustang, OK 73064-7201
Phone
(405) 376-9779
Fax
(405) 376-9668
NPI assigned
Jul 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Dr. Travis E. Partin, ODNPI 1982181855
Title
Owner
Phone
(405) 376-9779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1100 N Mustang Rd
Mustang, OK 73064-7201

Mailing address

1100 N Mustang Rd
Mustang, OK 73064-7201
Phone (405) 376-9779

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191209002000 OK Part B Supplier - Clinic/Group Practice 4587097340 Receives reassigned benefits from 2 practitioners
Practice locations: Mustang, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1194377168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647201",
            "telephone_number": "405-376-9779",
            "fax_number": "405-376-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647201",
            "telephone_number": "405-376-9779",
            "fax_number": "405-376-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTIN EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "PARTIN",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-376-9779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mustang, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.