Individual provider Active NPI

Tatyana Victoria Mayer, OD

  • Optometrist
  • Ponca City, OK
National Provider Identifier
1477560019
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2343 Issued in OK
Practice address
1722 N 4TH St Ste C
Ponca City, OK 74601-2745
Phone
(580) 762-0870
Fax
(580) 762-0871
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2343 OK Primary

Addresses

Primary practice location

1722 N 4TH St Ste C
Ponca City, OK 74601-2745

Mailing address

1722 N 4TH St Ste C
Ponca City, OK 74601-2745
Phone (580) 762-0870

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
I20050415000566 OK Practitioner - Optometry 9133179534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1722 N 4TH St
Suite C
Ponca City, OK 74601-2745
Phone (580) 762-0870

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2343OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayer Eye Care, Inc CurrentSince Feb 1, 2005 Accepting new patients

Locations

1722 N 4th St
Ste C
Ponca City, OK 74601
Phone (580) 762-0870

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1477560019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 N 4TH ST STE C",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012745",
            "telephone_number": "580-762-0870",
            "fax_number": "580-762-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 N 4TH ST STE C",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012745",
            "telephone_number": "580-762-0870",
            "fax_number": "580-762-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "TATYANA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

Verify at the official NPI Registry.