Organization Active NPI

Elite Eye Care PC

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1720345465
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2393 Issued in OK
Legal business name
ELITE EYE CARE PC
Practice address
14524 Bogert Pkwy
Oklahoma City, OK 73134-2629
Phone
(405) 848-8845
Fax
(405) 848-3570
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Anita Dawn Le, O.D.NPI 1982625679
Title
President
Phone
(405) 848-8845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2393 OK Primary

Addresses

Primary practice location

14524 Bogert Pkwy
Oklahoma City, OK 73134-2629

Mailing address

1901 NW Expressway
Suite 1082
Oklahoma City, OK 73118-1607
Phone (405) 848-8845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120522001144 OK Part B Supplier - Clinic/Group Practice 9739342114 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1901 NW Expressway
Ste 1082
Oklahoma City, OK 73118
Phone (405) 848-8845

14524 Bogert Pkwy
Oklahoma City, OK 73134
Phone (405) 848-8845

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1720345465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NW EXPRESSWAY",
            "address_2": "SUITE 1082",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181607",
            "telephone_number": "405-848-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14524 BOGERT PKWY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342629",
            "telephone_number": "405-848-8845",
            "fax_number": "405-848-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-848-8845",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.