Individual provider Active NPI

Charles Edward Ronan, OD

  • Optometrist
  • Tahlequah, OK
National Provider Identifier
1639696057
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2950 Issued in OK
Practice address
1001 N Grand Ave
Tahlequah, OK 74464-7017
Phone
(918) 444-2109
NPI assigned
Aug 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2950 OK Primary

Addresses

Primary practice location

1001 N Grand Ave
Tahlequah, OK 74464-7017

Mailing address

14701 N Santa Fe Ave
Edmond, OK 73013-3411
Phone (405) 752-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180801001520 OK Practitioner - Optometry 6608124003 Reassigns benefits to 2 organizations
I20231126000018 TX Practitioner - Optometry 6608124003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Britton Vision Associates IncGroup PAC ID 4688659519, 12 clinicians

Practice addresses (Care Compare)

14701 N Santa Fe Ave
Edmond, OK 73013-3411
Phone (405) 752-2733

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Jul 20, 2019 Accepting new patients
Creek Nation Hospital & Clinics Optometrist Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Oct 8, 2023 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 20, 2019 Accepting new patients
Britton Vision Associates Inc CurrentSince Jul 1, 2018 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

14701 N Santa Fe Ave
Edmond, OK 73013
Phone (405) 752-2733

1710 W 3rd St
Ste 100
Elk City, OK 73644
Phone (580) 255-1555

3151 W Tecumseh Rd
Ste 230
Norman, OK 73072
Phone (405) 310-3088

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

8100 S Walker Ave
Ste 200
Oklahoma City, OK 73139
Phone (405) 629-5343

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

1501 Airport Dr
Shawnee, OK 74804
Phone (405) 273-5801

1001 N Grand Ave
Tahlequah, OK 74464
Phone (918) 456-5511

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Interoperability endpoints

  • Direct secure messaging: cronan@bva.intellechartdirect.net

Organizations & group practices 6

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1639696057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 N SANTA FE AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133411",
            "telephone_number": "405-752-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-444-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONAN",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.