Individual provider Active NPI

Samuel Curtis Oliphant Jr., OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1396750139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
898 Issued in OK
Practice address
13321 N Meridian Ave
Suite 110
Oklahoma City, OK 73120
Phone
(405) 751-7727
Fax
(405) 755-1875
NPI assigned
Jul 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 898 OK Primary

Addresses

Primary practice location

13321 N Meridian Ave
Suite 110
Oklahoma City, OK 73120

Mailing address

13321 N Meridian Ave
Suite 110
Oklahoma City, OK 73120
Phone (405) 751-7727

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
I20100913000134 OK Practitioner - Optometry 3375612682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1975
Medicare assignment
May accept Medicare assignment
Group practices
Samuel C. Oliphant, IncGroup PAC ID 3375612674, 2 clinicians

Practice addresses (Care Compare)

14000 Quailbrook Dr
Oklahoma City, OK 73134-1701
Phone (405) 751-7727

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
898OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel C. Oliphant, Inc Optometrist CurrentSince Sep 18, 2002 Accepting new patients

Locations

14000 Quailbrook Dr
Oklahoma City, OK 73134
Phone (405) 751-7727

Organizations & group practices 1

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396750139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13321 N MERIDIAN AVE",
            "address_2": "SUITE 110",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-751-7727",
            "fax_number": "405-755-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13321 N MERIDIAN AVE",
            "address_2": "SUITE 110",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-751-7727",
            "fax_number": "405-755-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIPHANT",
        "first_name": "SAMUEL",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.