Ethan Paul Adre

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

39396 Issued in OK

Practice address

608 Stanton L Young Blvd
Oklahoma City, OK 73104-5014

Phone

(405) 271-7816

NPI assigned

Apr 18, 2022

Last updated

Sep 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Specialty

Ophthalmology

Education

University of Miami, LM Miller School of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1750024634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 STANTON L YOUNG BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045014",
            "telephone_number": "405-271-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 STANTON L YOUNG BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045014",
            "telephone_number": "405-271-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADRE",
        "first_name": "ETHAN",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "39396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advance Counseling PC
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• Ophthalmology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.