Brett James Wagner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2718 Issued in OK

Practice address

5606 SW Lee Blvd
Suite 301
Lawton, OK 73505-9688

Phone

(580) 536-0000

Fax

(580) 536-2205

NPI assigned

Jan 6, 2012

Last updated

Jun 13, 2012By the provider in NPPES

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

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

Southern College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Eye Institute PLLCGroup PAC ID 6507083557, 36 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.14 of 100Reported as individual

Quality

98.44

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Triad Eye Institute PLLC

  • Ophthalmology Physician
  • Tulsa, OK
  • NPI 1093743213

  Optometrist

  Medicare reassignment Care Compare group NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Triad Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Muskogee, OK
  • NPI 1043216617
  NPD (past)
• Triad Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Bartlesville, OK
  • NPI 1205439650
  NPD (past)
• Triad Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Tulsa, OK
  • NPI 1508862160
  NPD (past)
• Triad Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Grove, OK
  • NPI 1083030597
  NPD (past)

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1407126576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 SW LEE BLVD",
            "address_2": "SUITE 301",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059688",
            "telephone_number": "580-536-0000",
            "fax_number": "580-536-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 SW LEE BLVD",
            "address_2": "SUITE 301",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059688",
            "telephone_number": "580-536-0000",
            "fax_number": "580-536-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BRETT",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Volunteers of America of Oklahoma, Inc.
• Gayle Voyles, L.P.C.
• Wachita Kidney and Hypertension Specialists PLLC
• Deborah Wade
• Karen Michele Wade
• Jennifer Wahkinney, RN
• Noconi Wahkinney
• Kimberly Waite
• Katharina Belinda Wakefield
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2984)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.