Organization Active NPI

Eyecare of Western Oklahoma PC

  • Optometrist
  • Elk City, OK
National Provider Identifier
1265780761
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE OF WESTERN OKLAHOMA PC
Practice address
800 N Main St
Elk City, OK 73644-3414
Phone
(580) 225-1978
Fax
(580) 225-8648
NPI assigned
Aug 15, 2012
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Colby D Roberts, ODNPI 1972852820
Title
Owner
Phone
(580) 225-1980

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

800 N Main St
Elk City, OK 73644-3414

Mailing address

800 N Main St
Elk City, OK 73644-3414
Phone (580) 225-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121010000109 OK Part B Supplier - Clinic/Group Practice 4789833682 Receives reassigned benefits from 2 practitioners
Practice locations: Elk City, OK

National Provider Directory

National Provider Directory

Locations

101 N Randall Ave
Elk City, OK 73644
Phone (580) 225-1980

800 N Main St
Elk City, OK 73644
Phone (580) 225-1978

Practitioners & affiliated clinicians

Practitioners 3

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": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1265780761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736443414",
            "telephone_number": "580-225-1980",
            "fax_number": "580-225-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736443414",
            "telephone_number": "580-225-1978",
            "fax_number": "580-225-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE OF WESTERN OKLAHOMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "COLBY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-225-1980",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.