Individual provider Active NPI

Joana Cecilia Pantoja, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1679240709
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3144 Issued in OK
Practice address
14000 Quailbrook Dr.
Oklahoma City, OK 73134
Phone
(405) 751-7727
Fax
(405) 755-1875
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 3144 OK Primary

Addresses

Primary practice location

14000 Quailbrook Dr.
Oklahoma City, OK 73134

Mailing address

14000 Quailbrook Dr.
Oklahoma City, OK 73134
Phone (405) 751-7727

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
I20211208000535 OK Practitioner - Optometry 5991195844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Samuel C. Oliphant, Inc 2 clinicians

Practice addresses (Care Compare)

14000 Quailbrook Dr
Oklahoma City, OK 73134-1701
Phone (405) 751-7727

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3144OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel C. Oliphant, Inc Optometrist CurrentSince Sep 10, 2021 Accepting new patients

Locations

14000 Quailbrook Dr
Oklahoma City, OK 73134
Phone (405) 751-7727

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1679240709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 QUAILBROOK DR.",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-751-7727",
            "fax_number": "405-755-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 QUAILBROOK DR.",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-751-7727",
            "fax_number": "405-755-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "JOANA",
        "middle_name": "CECILIA",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.