- Medicare in Oklahoma City, OK

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is a medicare enrolled "Clinic/center - Multi-specialty" provider in Oklahoma City, Oklahoma. Their current practice location is 4301 N Classen Blvd, Oklahoma City, Oklahoma. You can reach out to their office (for appointments etc.) via phone at (405) 286-9699.

is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073827200.

Contact Information

4301 N Classen Blvd,
Oklahoma City, OK 73118-5031
(405) 286-9699
(918) 779-7794

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityClinic/center - Multi-specialty
Location4301 N Classen Blvd, Oklahoma City, Oklahoma
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073827200
  • Provider Enumeration Date: 07/29/2010
  • Last Update Date: 05/14/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 9133314594
  • Enrollment ID: O20101110001287

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073827200NPI-NPPES
200339810CMedicaidOK

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Secondary
152WL0500XOptometrist - Low Vision Rehabilitation (* (Not Available))Secondary
152WV0400XOptometrist - Vision Therapy (* (Not Available))Secondary
174H00000XHealth Educator (* (Not Available))Secondary
224Z00000XOccupational Therapy Assistant (* (Not Available))Secondary
224ZL0004XOccupational Therapy Assistant - Low Vision (* (Not Available))Secondary
225CA2400XRehabilitation Counselor - Assistive Technology Practitioner (* (Not Available))Secondary
225CX0006XRehabilitation Counselor - Orientation And Mobility Training Provider (* (Not Available))Secondary
225X00000XOccupational Therapist (* (Not Available))Secondary
225XL0004XOccupational Therapist - Low Vision (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary
261QR0401XClinic/center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (corf) (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameWesley J Derosier
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1760401764
PECOS PAC ID: 9234026170
Enrollment ID: I20120203000641
Provider NameJo Pongsatien
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1558747295
PECOS PAC ID: 9335438696
Enrollment ID: I20160510002181
Provider NameAshley Burkdoll
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1679085385
PECOS PAC ID: 6901272459
Enrollment ID: I20221025000825
Provider NameNanki Kaleka
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1124753108
PECOS PAC ID: 3678958873
Enrollment ID: I20221206001446
Provider NameAudrey Schnelle
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1629768270
PECOS PAC ID: 9638539984
Enrollment ID: I20230718001820
Provider NameNeil M Horner
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1821076829
PECOS PAC ID: 6901135813
Enrollment ID: I20230905002705
Provider NameJadica Piela
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1013612209
PECOS PAC ID: 5799123782
Enrollment ID: I20240614002250

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. 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 AddressPractice Location Address

501 N Douglas Ave,
Oklahoma City, OK 73106-5007

Ph: (405) 232-4644
4301 N Classen Blvd,
Oklahoma City, OK 73118-5031

Ph: (405) 286-9699

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.