Individual provider Active NPI

Bradley Adam Daniel, OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1689227217
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3020 Issued in OK
Practice address
5600 N Portland Ave
Oklahoma City, OK 73112-2023
Phone
(405) 943-4413
Fax
(405) 942-0115
NPI assigned
Jul 23, 2019
Last updated
Jul 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3020 OK Primary

Addresses

Primary practice location

5600 N Portland Ave
Oklahoma City, OK 73112-2023

Mailing address

5600 N Portland Ave
Oklahoma City, OK 73112-2023
Phone (405) 943-4413

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
I20200728001628 OK Practitioner - Optometry 4688098338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmond Regional Eye Associates IncGroup PAC ID 9133159924, 3 clinicians

Practice addresses (Care Compare)

920 S Bryant
Suite 100
Edmond, OK 73034-5803

920 S Bryant Ave
Suite 100
Edmond, OK 73034-5803
Phone (405) 341-4238

Merit-based Incentive Payment System (MIPS)

Final score
94.73 of 100Reported as group
Quality
89.45
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery99
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edmond Regional Eye Associates Inc CurrentSince Oct 4, 2021 Accepting new patients
Eyecare Associates of South Tulsa PC Optometrist PastSince Jul 28, 2019 Accepting new patients
Langley Holdings, LLC PastSince Jul 28, 2019 Accepting new patients

Locations

920 S Bryant Ave
Ste 100
Edmond, OK 73034
Phone (405) 341-4238

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1689227217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122023",
            "telephone_number": "405-943-4413",
            "fax_number": "405-942-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122023",
            "telephone_number": "405-943-4413",
            "fax_number": "405-942-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "BRADLEY",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.