Individual provider Active NPI

Bradley William Fielding

  • Optometrist
  • Edmond, OK
National Provider Identifier
1952301475
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK1080 Issued in OK
Practice address
13 N University Dr
Edmond, OK 73034-5206
Phone
(405) 341-3567
Fax
(405) 359-2000
NPI assigned
Jul 27, 2005
Last updated
Mar 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK1080 OK Primary

Addresses

Primary practice location

13 N University Dr
Edmond, OK 73034-5206

Mailing address

318 S Littler Ave
Edmond, OK 73034-3823
Phone (405) 341-3567

Other identifiers 1

IdentifierTypeStateIssuer
100763620AMedicaidOK

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
I20120515000024 OK Practitioner - Optometry 1355458191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkside Eyecare PLLCGroup PAC ID 5193141372, 4 clinicians

Practice addresses (Care Compare)

318 S Littler Ave
Edmond, OK 73034-3823
Phone (405) 341-3567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080OKMDHealth Service Psychologist
OK1080OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside Eyecare, PLLC Optometrist CurrentSince Oct 21, 2020 Accepting new patients

Locations

318 S Littler Ave
Edmond, OK 73034
Phone (405) 341-3567

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1952301475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 S LITTLER AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343823",
            "telephone_number": "405-341-3567",
            "fax_number": "405-359-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 N UNIVERSITY DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345206",
            "telephone_number": "405-341-3567",
            "fax_number": "405-359-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDING",
        "first_name": "BRADLEY",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK1080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100763620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.