NPIMap

Med Southwest, PLLC

Organization Active NPI Optometrist · Tulsa, OK

NPI 1952071995 · NPPES record last updated May 30, 2022

Key facts

NPI
1952071995
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
MED SOUTHWEST, PLLC
Practice address
8215 S Mingo Rd Ste 100
Tulsa, OK 74133-4671
Phone
(918) 252-7432
NPI assigned
Sep 20, 2021
Organization subpart
No

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 235

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

View all 235

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2097283Med Southwest, PLLC
8215 S Mingo Rd, Ste 100, Tulsa, OK 74133		Certificate of waiverJun 10, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Med Southwest, PLLC
8215 S Mingo Rd, Tulsa, OK 74133-4671 · (918) 252-7432		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Feb 25, 2019

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190411000911 OK Part B Supplier - Clinic/Group Practice 4082952874 Receives reassigned benefits from 43 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tulsa, OK; Oklahoma City, OK; Idabel, OK; Edmond, OK; Broken Bow, OK; Broken Arrow, OK
O20230414001564 OK DME Supplier - Physician - Optometrist 4082952874 Practice locations: Tulsa, OK

National Provider Directory

Tax ID family
Med Southwest PLLC (154 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X Yes

Addresses

Primary practice location

8215 S Mingo Rd Ste 100
Tulsa, OK 74133-4671

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names

  • MyEyeDr. Doing business as

Other providers in Tulsa, OK

All providers in Tulsa, OK · Optometrist in Oklahoma

Sources for this page

Verify at the official NPI Registry.