Individual provider Active NPI

Kenneth James Merchant, O.D.

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1619059235
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2074 Issued in OK
Practice address
3334 E 32ND PL
Tulsa, OK 74135-4415
Phone
(918) 622-6244
Fax
(918) 622-9126
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2074 OK Primary

Addresses

Primary practice location

3334 E 32ND PL
Tulsa, OK 74135-4415

Mailing address

3334 E 32ND PL
Tulsa, OK 74135-4415
Phone (918) 622-6244

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
I20110302000826 OK Practitioner - Optometry 0345422937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4853 S Sheridan Rd
Ste. 607
Tulsa, OK 74145-5720
Phone (918) 622-6244

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2074OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ken Merchant,O.D. PLLC Optometrist CurrentSince Jan 11, 2011 Accepting new patients

Locations

3334 E 32nd Pl
Tulsa, OK 74135
Phone (918) 622-6244

4853 S Sheridan Rd
Ste 607
Tulsa, OK 74145
Phone (918) 622-6244

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1619059235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E 32ND PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354415",
            "telephone_number": "918-622-6244",
            "fax_number": "918-622-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 E 32ND PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354415",
            "telephone_number": "918-622-6244",
            "fax_number": "918-622-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.