Individual provider Active NPI

Aaron Michael Scavezze, OD

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1215922737
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2229 Issued in OK
Practice address
10651 E 31St St
Tulsa, OK 74146-1602
Phone
(918) 437-6360
Fax
(918) 437-6362
NPI assigned
Sep 12, 2005
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2229 OK Primary

Addresses

Primary practice location

10651 E 31St St
Tulsa, OK 74146-1602

Mailing address

10651 E 31St St
Tulsa, OK 74146-1602
Phone (918) 437-6360

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
I20131105000438 OK Practitioner - Optometry 5395970032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2229OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastland Eye Care Associates PLLC Optometrist Current Accepting new patients
Aaron M Scavezze OD, PC Optometrist CurrentSince Apr 23, 2013 Accepting new patients

Locations

10651 E 31st St
Tulsa, OK 74146
Phone (918) 437-0677

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1215922737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741461602",
            "telephone_number": "918-437-6360",
            "fax_number": "918-437-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10651 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741461602",
            "telephone_number": "918-437-6360",
            "fax_number": "918-437-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAVEZZE",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.