Individual provider Active NPI

Carolanne Hope Roach, OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1548416423
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2581 Issued in OK
Practice address
1530 SW 89TH St Ste D6
Oklahoma City, OK 73159-6366
Phone
(405) 703-3163
Fax
(405) 353-6718
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 2581 OK
Pediatric Optometrist 152WP0200X 2581 OK
Sports Vision Optometrist 152WS0006X 2581 OK
Vision Therapy Optometrist 152WV0400X 2581 OK
Optometrist 152W00000X 2581 OK Primary
Occupational Vision Optometrist 152WX0102X 2581 OK

Addresses

Primary practice location

1530 SW 89TH St Ste D6
Oklahoma City, OK 73159-6366

Mailing address

1530 SW 89TH St Ste D6
Oklahoma City, OK 73159-6366
Phone (405) 703-3163

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
I20121112000253 OK Practitioner - Optometry 4688731185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1530 SW 89TH St
Suite D2
Oklahoma City, OK 73159-6366
Phone (405) 703-3163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2581OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Eye Connection Vision Clinic, PC CurrentSince Jan 23, 2009 Accepting new patients
Cherokee Nation Past Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients

Locations

1530 SW 89th St
Ste D-6
Oklahoma City, OK 73159
Phone (405) 703-3163

1530 SW 89th St
Ste D2
Oklahoma City, OK 73159
Phone (405) 703-3163

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
  • Direct secure messaging: brainandeye@brain-and-eye-connection.direct.kno2fy.com

Organizations & group practices 3

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1548416423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SW 89TH ST STE D6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596366",
            "telephone_number": "405-703-3163",
            "fax_number": "405-353-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SW 89TH ST STE D6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596366",
            "telephone_number": "405-703-3163",
            "fax_number": "405-353-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "CAROLANNE",
        "middle_name": "HOPE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "OK",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OK",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OK",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OK",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2581",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OK",
            "license": "2581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.