Individual provider Active NPI

Darin Michael Shupert, O.D.

  • Optometrist
  • Idabel, OK
National Provider Identifier
1740378710
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2082 Issued in OK
Practice address
124 SE Ave N
Idabel, OK 74745-5234
Phone
(580) 286-2020
Fax
(580) 286-2305
NPI assigned
Oct 11, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2082 OK Primary

Addresses

Primary practice location

124 SE Ave N
Idabel, OK 74745-5234

Mailing address

124 SE Ave N
Idabel, OK 74745-5234
Phone (580) 286-2020

Other identifiers 1

IdentifierTypeStateIssuer
100765040AMedicaidOK

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
I20110111000121 OK Practitioner - Optometry 8527257351 Reassigns benefits to 1 organization
Practice locations: Idabell, OK

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

1425 E Lincoln Rd
A1 Med Southwest PLLC Dba Texarkana E
Idabel, OK 74745-7345
Phone (580) 286-6000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest PLLC Optometrist CurrentSince Dec 9, 2019 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Dec 9, 2019 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

1425 E Lincoln Rd
Ste A1
Idabel, OK 74745
Phone (580) 286-6000

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: dshupert016970@myeyedr.emadirect.md

Organizations & group practices 4

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1740378710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SE AVE N",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747455234",
            "telephone_number": "580-286-2020",
            "fax_number": "580-286-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SE AVE N",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747455234",
            "telephone_number": "580-286-2020",
            "fax_number": "580-286-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPERT",
        "first_name": "DARIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765040A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.