NPIMap

Individual provider Active NPI

Komal Patel

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1306417308
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002925 Issued in AZ
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-5011
Fax
(602) 655-9133
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002925 AZ Primary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3146 OK

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone (602) 344-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX, AZ3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210819002372 OK Practitioner - Optometry 6204231897 Reassigns benefits to 1 organization
I20211222000531 TX Practitioner - Optometry 6204231897 Reassigns benefits to 1 organization
I20260507000641 AZ Practitioner - Optometry 6204231897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians
Northeastern State University College of OptometryGroup PAC ID 0941112528, 20 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone (602) 344-1015

900 N Owen Walters Blvd
Salina, OK 74365-5003
Phone (918) 444-4034

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002925AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty CurrentSince Sep 17, 2021 Accepting new patients
Northeastern State University College of Optometry Optometrist CurrentSince Jul 20, 2021 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation CurrentSince Sep 17, 2021 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

1001 N Grand Ave
Tahlequah, OK 74464
Phone (918) 456-5511

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

870 E Crafton St
Tahlequah, OK 74464
Phone (918) 444-4000

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 9

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1306417308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-5011",
            "fax_number": "602-655-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-5011",
            "fax_number": "602-655-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "002925",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.