Individual provider Active NPI

Wesley Alan Rainwater, O.D.

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1982719571
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK985 Issued in OK
Practice address
8122 S Memorial Dr
Tulsa, OK 74133-4309
Phone
(918) 254-0447
Fax
(918) 252-5753
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK985 OK Primary

Addresses

Primary practice location

8122 S Memorial Dr
Tulsa, OK 74133-4309

Mailing address

8122 S Memorial Dr
Tulsa, OK 74133-4309
Phone (918) 254-0447

Other identifiers 1

IdentifierTypeStateIssuer
100759910AMedicaidOK

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
I20101124001057 OK Practitioner - Optometry 7911193339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Ophthalmology PCGroup PAC ID 3577592682, 8 clinicians
Harrel Vision PLLCGroup PAC ID 2567812001, 2 clinicians

Practice addresses (Care Compare)

4606 E 67TH St
Suite 400
Tulsa, OK 74136-4950
Phone (918) 949-9898

8122 S Memorial Dr
Tulsa, OK 74133-4309
Phone (918) 254-0447

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OK985OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harrel Vision, PLLC Optometrist CurrentSince May 1, 2024 Accepting new patients

Locations

8122 S Memorial Dr
Tulsa, OK 74133
Phone (918) 254-0447

8122 S Memorial Dr
Ste A
Tulsa, OK 74133

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982719571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334309",
            "telephone_number": "918-254-0447",
            "fax_number": "918-252-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8122 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334309",
            "telephone_number": "918-254-0447",
            "fax_number": "918-252-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINWATER",
        "first_name": "WESLEY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100759910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.