Mr Max L Carlisle, OD is a medicare enrolled "Optometrist" provider in Fairview, Oklahoma. He went to University Of Houston - College Of Optometry and graduated in 1980 and has 44 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Be Thou My Vision Pc and his current practice location is
111 E Broadway, Fairview, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 227-4878.
Mr Max L Carlisle is licensed to practice in Oklahoma (license number 973) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1205839685.
Healthcare Provider's Profile
| Full Name | Mr Max L Carlisle |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 44 Years |
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| Location | 111 E Broadway, Fairview, Oklahoma |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Max L Carlisle attended and graduated from University Of Houston - College Of Optometry in 1980
NPI Data:
- NPI Number: 1205839685
- Provider Enumeration Date: 05/31/2005
- Last Update Date: 12/23/2013
Medicare PECOS Information:
- PECOS PAC ID: 3072695485
- Enrollment ID: I20080124000177
Medical Identifiers
Medical identifiers for Mr Max L Carlisle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205839685 | NPI | - | NPPES |
| 0246290001 | Other | OK | PALMETTO DMERC |
| 100766110A | Medicaid | OK | |
| 410046324 | Other | OK | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 973 (Oklahoma) | Primary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 973 (Oklahoma) | Secondary |
| 152WL0500X | Optometrist - Low Vision Rehabilitation | 973 (Oklahoma) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 973 (Oklahoma) | Secondary |
| 152WS0006X | Optometrist - Sports Vision | 973 (Oklahoma) | Secondary |
| 152WV0400X | Optometrist - Vision Therapy | 973 (Oklahoma) | Secondary |
| 152WX0102X | Optometrist - Occupational Vision | 973 (Oklahoma) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Be Thou My Vision Pc | 5496837957 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Max L Carlisle allows following entities to bill medicare on his behalf.
| Provider Name | Be Thou My Vision Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1225183957
PECOS PAC ID: 5496837957
Enrollment ID: O20080123000668 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Max L Carlisle is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Max L Carlisle, OD
111 E Broadway,
Fairview, OK 73737-2124
Ph: (580) 227-4878 | Mr Max L Carlisle, OD
111 E Broadway,
Fairview, OK 73737-2124
Ph: (580) 227-4878 |
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