Individual provider Active NPI

Chadwick Branch, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1962810085
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2803 Issued in OK
Practice address
5622 N Portland Ave
Ste 200
Oklahoma City, OK 73112-2096
Phone
(405) 528-8193
NPI assigned
Aug 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 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 2803 OK Primary

Addresses

Primary practice location

5622 N Portland Ave
Ste 200
Oklahoma City, OK 73112-2096

Mailing address

5622 N Portland Ave
Ste 200
Oklahoma City, OK 73112-2096
Phone (405) 528-8193

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
I20141223000547 OK Practitioner - Optometry 1355664301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4400 Grant Blvd
Suite 106
Yukon, OK 73099-0038
Phone (405) 603-4744

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2803OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Optometrists of Oklahoma Inc Optometrist PastSince Feb 10, 2018 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1962810085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 N PORTLAND AVE",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122096",
            "telephone_number": "405-528-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5622 N PORTLAND AVE",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122096",
            "telephone_number": "405-528-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "CHADWICK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.