South Tulsa Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SOUTH TULSA OPTICAL, INC.

Practice address

7171 S Yale Ave
Tulsa, OK 74136-6374

Phone

(918) 494-0351

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Trainer, A.B.O.C.

Title

General Manager

Phone

(918) 494-0351

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee E Schoeffler, M.D.

  • Ophthalmology Physician
  • Tulsa, OK
  • NPI 1225035108
  NPD (past)
• Jamal Dean Siddiqui, M.D.

  • Ophthalmology Physician
  • Tulsa, OK
  • NPI 1578883336
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1891896932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366374",
            "telephone_number": "918-494-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TULSA OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "TRAINER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "918-494-0351",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "A.B.O.C."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "112361",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Tulsa ASC, LLC
• South Tulsa Family Pracitce Inc
• South Tulsa Imaging, L.L.C.
• South Tulsa Medical Group LLC
• South Tulsa Open MRI, LLC
• South Tulsa Pediatrics PLLJ
• South Tulsa Performance Health
• South Tulsa Pet, L.L.C.
• South Tulsa Retina
• South Tulsa RT Associates LLC

• All providers in Tulsa, OK
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.