Jeffery Dale Elliott, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2241 Issued in OK

Practice address

1139 N Hills Ctr
Ada, OK 74820-1882

Phone

(580) 332-6000

Fax

(580) 332-6006

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elliott Vision Care, PLLC

  • Optometrist
  • Ada, OK
  • NPI 1023477106
  Medicare reassignment Authorized official
• Ada Family Eye Care Inc

  • Optometrist
  • Ada, OK
  • NPI 1285767848
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1780766592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 N HILLS CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201882",
            "telephone_number": "580-332-6000",
            "fax_number": "580-332-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 N HILLS CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201882",
            "telephone_number": "580-332-6000",
            "fax_number": "580-332-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JEFFERY",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100762790A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Dorcel Edwards, M.S.
• Kayla Effinger
• Derick Allen Eidson
• Melissa Eidson
• Elliott Vision Care, PLLC
• Tarin Elliott, DPT
• Andrew Ellis
• Melanie Faye Ellison
• Jamison Elston, PTA
• Ginger Emrich, DPH

• Optometrist in Ada, OK
• Providers in Ada, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.