Individual provider Active NPI

Kaylee Bobbitt

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1972295400
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3214 Issued in OK
Practice address
5910 S Lewis Ave
Tulsa, OK 74105-7112
Phone
(918) 745-9700
Fax
(918) 743-8102
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3214 OK Primary

Addresses

Primary practice location

5910 S Lewis Ave
Tulsa, OK 74105-7112

Mailing address

5910 S Lewis Ave
Tulsa, OK 74105-7112
Phone (918) 745-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230913003971 AZ Practitioner - Optometry 9537523220 Reassigns benefits to 1 organization
I20260609001407 OK Practitioner - Optometry 9537523220 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

6615 N Oracle Rd
Tucson, AZ 85704-5644
Phone (520) 797-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002721AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John H McDougall OD Arizona PC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Andrea B Dudley OD, Inc PC Optometrist PastSince Jun 15, 2011 Accepting new patients
Kolker Vision Care Optometrist Past Accepting new patients

Locations

13125 N La Montana Dr
Ste 1
Fountain Hls, AZ 85268
Phone (480) 816-0102

6615 N Oracle Rd
Tucson, AZ 85704
Phone (520) 797-8000

111 E 4th St
Ste 440
Alton, IL 62002

Organizations & group practices 4

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1972295400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057112",
            "telephone_number": "918-745-9700",
            "fax_number": "918-743-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057112",
            "telephone_number": "918-745-9700",
            "fax_number": "918-743-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBITT",
        "first_name": "KAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.