John R Diver, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2726 Issued in OK

Practice address

4606 E. 67TH St
Suite 400, BLDG. #7
Tulsa, OK 74136

Phone

(918) 949-9898

Fax

(918) 728-8091

NPI assigned

Jun 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

New England College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Ophthalmology PCGroup PAC ID 3577592682, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pediatric Ophthalmology, PC

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Tulsa, OK
  • NPI 1447244827
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1336586122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 E. 67TH ST",
            "address_2": "SUITE 400, BLDG. #7",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-949-9898",
            "fax_number": "918-728-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 E. 67TH ST",
            "address_2": "SUITE 400, BLDG. #7",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-949-9898",
            "fax_number": "918-728-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVER",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200498350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audie Dison
• Judy A Distefano, D.O.
• Ronald Francis Distefano, D.O.
• Samantha Dittmer
• Julianna Whiteley Dittus
• Byron Conrad Dixon Jr.
• Casey Dixon
• Christel L Dixon, DO
• Coquestia Dixon, MHR
• Courtney Jean Dixon, LPC

• Optometrist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.