Individual provider Active NPI

Stacey Murrell, OD

  • Optometrist
  • Broken Arrow, OK
National Provider Identifier
1619984481
Registry record updated Apr 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK2345 Issued in OK
Practice address
521 S Aspen Ave
Broken Arrow, OK 74012-2296
Phone
(918) 258-9999
Fax
(918) 258-2850
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK2345 OK Primary

Addresses

Primary practice location

521 S Aspen Ave
Broken Arrow, OK 74012-2296

Mailing address

521 S Aspen Ave
Broken Arrow, OK 74012-2296
Phone (918) 258-9999

Other identifiers 1

IdentifierTypeStateIssuer
100762280AMedicaidOK

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
I20090312000217 OK Practitioner - Optometry 5395801682 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
Group practices
Ba VisionGroup PAC ID 2860558152, 2 clinicians

Practice addresses (Care Compare)

521 S Aspen Ave
Broken Arrow, OK 74012-2296
Phone (918) 258-9999

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2345OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ba Vision Optometrist CurrentSince Dec 1, 2008 Accepting new patients
Stacey Murrell, OD PC Inc Optometrist Past Accepting new patients
Colby Beats, OD PC Inc Optometrist Past Accepting new patients

Locations

521 S Aspen Ave
Broken Arrow, OK 74012
Phone (918) 258-9999

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240617600000",
    "number": "1619984481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122296",
            "telephone_number": "918-258-9999",
            "fax_number": "918-258-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122296",
            "telephone_number": "918-258-9999",
            "fax_number": "918-258-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2009-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK2345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100762280A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.