NPIMap

Organization Active NPI

Oklahoma Eye Institute

  • Ophthalmology Physician
  • Elk City, OK
National Provider Identifier
1780011734
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
23117 Issued in OK
Legal business name
OKLAHOMA EYE INSTITUTE
Practice address
1020 N Main St
Elk City, OK 73644-2831
Phone
(580) 225-1555
Fax
(580) 225-1558
NPI assigned
Oct 7, 2013
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Kamran Massoumi, M.D.NPI 1639172604
Title
Owner
Phone
(580) 225-1555

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2167 OK
Optometrist 152W00000X 2718 OK
Ophthalmology Physician 207W00000X 23117 OK Primary

Addresses

Primary practice location

1020 N Main St
Elk City, OK 73644-2831

Mailing address

1020 N Main St
Elk City, OK 73644-2831
Phone (580) 225-1555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140121001788 OK Part B Supplier - Clinic/Group Practice 1759519754 Receives reassigned benefits from 6 practitioners
Practice locations: Oklahoma City, OK; Moore, OK; Lawton, OK; Elk City, OK

National Provider Directory

National Provider Directory

Locations

1710 W 3rd St
Ste 100
Elk City, OK 73644
Phone (580) 255-1555

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1780011734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736442831",
            "telephone_number": "580-225-1555",
            "fax_number": "580-225-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736442831",
            "telephone_number": "580-225-1555",
            "fax_number": "580-225-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA EYE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-07",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "MASSOUMI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-225-1555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2167",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2718",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "23117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.