Brent Plaxico, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2823 Issued in OK

Practice address

12406 E 86TH St N
Owasso, OK 74055-2500

Phone

(918) 376-2700

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Nova Southeastern Univ College of Dental Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Irefract PCGroup PAC ID 9739598343, 3 clinicians

Brett Enyart OD PLLCGroup PAC ID 9537310404, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brett Enyart, OD, PLLC

  • Optometrist
  • Skiatook, OK
  • NPI 1932458528
  Medicare reassignment Care Compare group NPD
• Irefract PC

  • Optometrist
  • Louisville, KY
  • NPI 1679166193

  OK

  Medicare reassignment Care Compare group NPD
• Perini Eyecare, PLLC

  • Optometrist
  • Tulsa, OK
  • NPI 1801331129
  Medicare reassignment NPD
• Advantage Eyecare, P.C.

  • Optometrist
  • Skiatook, OK
  • NPI 1720116932
  NPD (past)
• Thomas Dental Care, P.C.

  • General Practice Dentistry
  • Owasso, OK
  • NPI 1528019114
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1922012962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12406 E 86TH ST N",
            "address_2": "5201",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552500",
            "telephone_number": "918-376-2700",
            "fax_number": "918-376-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12406 E 86TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552500",
            "telephone_number": "918-376-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAXICO",
        "first_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1412",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A677",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14125",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Pilgrim
• Pine Ridge Mental Healthcare, LLC
• Pinnacle Healthcare of Oklahoma LLP
• Pinnacle Healthcare of Oklahoma, LLP
• Pivotal Pathways LLC
• Lauretta Jem Pontiflet
• Jone Post, D.PH.
• Marcus C Potter
• Ashley Poulin, PTA
• Timothy Blake Poulter, PHARM D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.