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DR. BLAKE CARLISLE O.D.
NPI 1073921524
Optometrist in Fairview, OK

Active since July 29, 2014PECOS EnrolledAccepts Medicare Assignment
111 E BROADWAY, FAIRVIEW, OK 73737(580) 227-4878(580) 227-4666 Get Directions Write a Review

NPPES record last updated: July 29, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Blake Carlisle O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BLAKE CARLISLE O.D. (NPI 1073921524) is an individual optometrist in Fairview, Oklahoma, licensed in Oklahoma (2804) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with Fairview Regional Medical Center Authority, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1073921524
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. BLAKE CARLISLECredential: O.D.
Location Address111 E BROADWAYFairview, OK 73737-2124
Mailing Address111 E BroadwayFairview, OK 73737-2124 · (580) 227-4878 · Fax (580) 227-4666
Phone(580) 227-4878
Fax(580) 227-4666
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 29, 2014
✔ NPI 1073921524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in OK · 2804
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
111 E BROADWAY, Fairview, OK 73737
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, CommunityCare, Mending Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Blake Carlisle O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638390826
PECOS Enrollment IDI20141103000978
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Blake Carlisle reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Be Thou My Vision, PC
Same address
Optometrist
111 E BROADWAY
Fairview, OK 73737
  • Reassigned Medicare billing, Oklahoma enrollment
  • 4 clinicians in this Medicare group
NPI 1225183957 (580) 227-4878
Northeastern State University College Of Optometry
198 mi
Optometrist
1001 N GRAND AVE
Tahlequah, OK 74464
  • Reassigned Medicare billing, Oklahoma enrollment
  • 96 clinicians in this Medicare group
NPI 1437106333 (918) 458-2109

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
338 services277 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
99 services89 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
68 services55 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
37 services37 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
32 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
32 services32 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Fairview Regional Medical Center Authority

Critical Access Hospitals · Fairview, OK
OwnershipGovernment - Hospital District or Authority
CMS Certification Number371329
Location523 East State RoadFairview, OK 73737 · Major County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73737 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier12 claims12 services$41.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MAX L CARLISLE O.D.
Optometrist
111 E BROADWAY
FAIRVIEW, OK 73737
Major County (580) 227-4878
BE THOU MY VISION, PC
Optometrist
111 E BROADWAY
FAIRVIEW, OK 73737
Major County (580) 227-4878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Carlisle's NPI number?

The NPI number for Blake Carlisle is 1073921524. It was assigned to this individual provider in the NPPES registry on July 29, 2014.

Where is Blake Carlisle located?

Blake Carlisle practices at 111 E Broadway, Fairview, OK 73737. The listed phone number is (580) 227-4878.

What is Blake Carlisle's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Blake Carlisle enrolled in Medicare?

Yes. Blake Carlisle is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Blake Carlisle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blake Carlisle reassigns Medicare benefits to 2 organizations: Be Thou My Vision, PC (Fairview, OK) and Northeastern State University College Of Optometry (Tahlequah, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blake Carlisle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Blake Carlisle accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, CommunityCare, Mending Health, Oscar Health Insurance and Oscar Health Maintenance Organization of Florida and 5 other insurers list Blake Carlisle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Blake Carlisle affiliated with any hospitals?

According to CMS data, Blake Carlisle is affiliated with Fairview Regional Medical Center Authority.

When was this NPI record last updated?

The NPPES record for Blake Carlisle was last updated on July 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.