Individual provider Active NPI

John Brian Cheatham, OD

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1992809032
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2356OK Issued in OK
Practice address
4433 South Harvard
Tulsa, OK 74135-2604
Phone
(918) 743-6334
Fax
(918) 743-6369
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2356OK OK Primary

Addresses

Primary practice location

4433 South Harvard
Tulsa, OK 74135-2604

Mailing address

4433 South Harvard
Tulsa, OK 74135-2604
Phone (918) 743-6334

Other identifiers 1

IdentifierTypeStateIssuer
200023450AMedicaidOK

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
I20040406000702 OK Practitioner - Optometry 7315930336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4433 S Harvard Ave
Tulsa, OK 74135-2604
Phone (918) 743-6334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2356OKOKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Eyecare, P.C. Optometrist Past Accepting new patients
Brett Enyart, OD, PLLC Optometrist PastSince Oct 15, 2012 Accepting new patients

Organizations & group practices 3

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1992809032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 SOUTH HARVARD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352604",
            "telephone_number": "918-743-6334",
            "fax_number": "918-743-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 SOUTH HARVARD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352604",
            "telephone_number": "918-743-6334",
            "fax_number": "918-743-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "JOHN",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2356OK",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200023450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.