Individual provider Active NPI

Kelsey Buford, OD

  • Optometrist
  • Fort Gibson, OK
National Provider Identifier
1821641267
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3015 Issued in OK
Practice address
330 W Highway 62
Fort Gibson, OK 74434-8446
Phone
(918) 478-8888
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2801 AR
Optometrist 152W00000X 3015 OK Primary

Addresses

Primary practice location

330 W Highway 62
Fort Gibson, OK 74434-8446

Mailing address

22928 E 730 Rd
Tahlequah, OK 74464-8402
Phone (605) 933-1574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190828001839 OK Practitioner - Optometry 1658609664 Reassigns benefits to 3 organizations
I20200318000604 TX Practitioner - Optometry 1658609664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Gibson Family Eyecare PLLCGroup PAC ID 1557808599, 2 clinicians

Practice addresses (Care Compare)

330 W Hwy 62
Fort Gibson, OK 74434-8446
Phone (918) 478-8888

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2801ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Mar 1, 2020 Accepting new patients
Tahlequah Family Vision Clinic, PLLC Optometrist CurrentSince Jul 24, 2019 Accepting new patients
Fort Gibson Family Eyecare PLLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Northeastern State University College of Optometry Optometrist CurrentSince Mar 1, 2020 Accepting new patients
Cherokee Nation CurrentSince Mar 1, 2020 Accepting new patients

Locations

330 W Highway 62
Fort Gibson, OK 74434
Phone (682) 201-4938

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

870 E Crafton St
Tahlequah, OK 74464
Phone (918) 444-4000

1640 W Keetoowah St
Tahlequah, OK 74464
Phone (918) 456-2250

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

681 W Choctaw St
Tahlequah, OK 74464
Phone (918) 456-2250

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1821641267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22928 E 730 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744648402",
            "telephone_number": "605-933-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W HIGHWAY 62",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348446",
            "telephone_number": "918-478-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "KELSEY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2801",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

Verify at the official NPI Registry.