EDMOND OPTICAL SHOP, INC. NPI 1003022773

Eyewear Supplier in Edmond, OK

NPI 1003022773 Organization Eyewear Supplier Medicare Supplier Does Not Accept Medicare Approved Payment

NPI Profile for EDMOND OPTICAL SHOP, INC.

Edmond Optical Shop, Inc. is a provider established in Edmond, Oklahoma specializing in eyewear supplier. The NPI number of Edmond Optical Shop, Inc. is 1003022773 and was assigned on May 2007. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mr. Lonnie B. Masters (Owneroptician)

Edmond Optical Shop, Inc. is a medicare supplier with PTAN 0699470001 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses.

NPI

1003022773

Provider NameEDMOND OPTICAL SHOP, INC.
Provider Location Address920 S BRYANT AVE SUITE 101 EDMOND, OK 73034
Provider Mailing Address920 S BRYANT AVE SUITE 101 EDMOND, OK 73034
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-16-2007
Last Update Date05-20-2010


Primary Taxonomy

Taxonomy Code332H00000X
ClassificationEyewear Supplier
TypeSuppliers
Taxonomy DescriptionAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Business Address

EDMOND OPTICAL SHOP, INC.
920 S BRYANT AVE
SUITE 101
EDMOND, OK
ZIP 73034
Phone: (405) 341-6588
Fax: (405) 348-9537

Get Directions


Mailing Address

EDMOND OPTICAL SHOP, INC.
920 S BRYANT AVE
SUITE 101
EDMOND, OK
ZIP 73034
Phone: (405) 341-6588
Fax: (405) 348-9537



Authorized Official

Authorized Official NameMR. LONNIE B. MASTERS
Authorized Official TitleOWNEROPTICIAN
Authorized Official Phone(405) 341-6588

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN0699470001
Accepts Medicare AssignmentNO
Specialities ListOptician.
Supplies List
  • Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
Competitive BiddingNO

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0699470001MEDICARE NSC (07)OK

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003022773
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003024714
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 4 + 7 + 1 + 4 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1003022773 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093704793 ROBERT D GOURLEY MD
Individual
Ophthalmology920 S BRYANT AVE STE 100
EDMOND, OK 73034
(405) 341-4238
1902895600 MICHAEL ANDREW HOGUE MD
Individual
Ophthalmology920 S BRYANT AVE SUITE 100
EDMOND, OK 73034
(405) 341-4238

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Edmond Optical Shop, Inc. is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.