Individual provider Active NPI

Bruce Alan Clifton, O.D.

  • Optometrist
  • Claremore, OK
National Provider Identifier
1912092727
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2009 Issued in OK
Practice address
421 N Lynn Riggs Blvd
Claremore, OK 74017-5617
Phone
(918) 343-7300
Fax
(918) 343-7337
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2009 OK Primary

Addresses

Primary practice location

421 N Lynn Riggs Blvd
Claremore, OK 74017-5617

Mailing address

421 N Lynn Riggs Blvd
Claremore, OK 74017-5617
Phone (918) 343-7300

Other identifiers 1

IdentifierTypeStateIssuer
100765080AMedicaidOK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050518000165 OK Practitioner - Optometry 5092765958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

421 N Lynn Riggs Blvd
Claremore, OK 74017-5617
Phone (918) 343-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Claremore Vision Center, Inc Optometrist CurrentSince Jan 15, 2005 Accepting new patients

Locations

421 N Lynn Riggs Blvd
Claremore, OK 74017
Phone (918) 343-7300

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1912092727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175617",
            "telephone_number": "918-343-7300",
            "fax_number": "918-343-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175617",
            "telephone_number": "918-343-7300",
            "fax_number": "918-343-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765080A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.