Individual provider Active NPI

Steven B Moyer, O.D., M.P.H.

  • Optometrist
  • Edmond, OK
National Provider Identifier
1215071881
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1090 Issued in OK
Practice address
833 E 33Rd St
Edmond, OK 73013-5407
Phone
(405) 216-5508
Fax
(405) 216-5841
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1090 OK Primary

Addresses

Primary practice location

833 E 33Rd St
Edmond, OK 73013-5407

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

3012 E Memorial Rd
Edmond, OK 73013-7000
Phone (405) 478-3040

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
I20120926000642 OK Practitioner - Optometry 9537318027 Reassigns benefits to 1 organization
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients

Locations

833 E 33rd St
Edmond, OK 73013
Phone (405) 216-5508

1425 E Lincoln Rd
Ste A1
Idabel, OK 74745
Phone (580) 286-6000

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: smoyer018268@myeyedr.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1215071881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135407",
            "telephone_number": "405-216-5508",
            "fax_number": "405-216-5841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3012 E Memorial Rd",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730137000",
            "country_code": "US",
            "telephone_number": "405-478-3040",
            "fax_number": "405-478-7098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYER",
        "first_name": "STEVEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.