Individual provider Active NPI

Roshan Patel, OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1477162923
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3093 Issued in OK
Practice address
11308 N Pennsylvania Ave
Oklahoma City, OK 73120-7752
Phone
(866) 630-7215
NPI assigned
Jul 29, 2020
Last updated
Jul 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3093 OK Primary

Addresses

Primary practice location

11308 N Pennsylvania Ave
Oklahoma City, OK 73120-7752

Mailing address

1305 S Broadway
Edmond, OK 73034-3952
Phone (405) 341-6068

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
I20200820000732 OK Practitioner - Optometry 7719303726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocular Physicians AssociatesGroup PAC ID 0941276190, 2 clinicians

Practice addresses (Care Compare)

11308 N Pennsylvania Ave
Oklahoma City, OK 73120-7752
Phone (405) 755-7700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3093OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ocular Physicians Associates Optometrist CurrentSince Aug 13, 2020 Accepting new patients

Locations

11308 N Pennsylvania Ave
Oklahoma City, OK 73120
Phone (405) 755-7700

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1477162923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S BROADWAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343952",
            "telephone_number": "405-341-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11308 N PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731207752",
            "telephone_number": "866-630-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.