Northeastern State University College of Optometry
NPI 1437106333 · Optometrist · Tahlequah, OK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Northeastern State University College of Optometry is a Optometrist organization in Tahlequah, OK (NPI 1437106333).
Provider details
- NPI number
- 1437106333
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Douglas Penisten, Dean(918) 456-5511
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
- Low Vision Rehabilitation Optometrist152WL0500X
Eye and Vision Services Providers
- Pediatric Optometrist152WP0200X
Eye and Vision Services Providers
- Vision Therapy Optometrist152WV0400X
Eye and Vision Services Providers
- Occupational Vision Optometrist152WX0102X
Eye and Vision Services Providers
- Sports Vision Optometrist152WS0006X
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Northeastern State University Oklahoma College of Optometry
Registry dates
- Enumerated
- 2006-05-27
- Last updated
- 2010-08-30
Frequently asked questions
- What is Northeastern State University College of Optometry's NPI number?
- Northeastern State University College of Optometry's National Provider Identifier (NPI) is 1437106333, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northeastern State University College of Optometry?
- Northeastern State University College of Optometry is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Northeastern State University College of Optometry located?
- Northeastern State University College of Optometry's practice location on file with NPPES is 1001 N Grand Ave, Tahlequah, OK 74464-7017.
- What is Northeastern State University College of Optometry's phone number?
- The practice phone number listed in the NPPES registry for Northeastern State University College of Optometry is (918) 458-2109.
- Does Northeastern State University College of Optometry accept Medicare?
- Northeastern State University College of Optometry is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Northeastern State University College of Optometry?
- The authorized official listed on Northeastern State University College of Optometry's NPPES record is Douglas Penisten, Dean. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northeastern State University College of Optometry's NPI active?
- Yes — Northeastern State University College of Optometry's NPI (1437106333) is active in the NPPES registry as of the last update on 2010-08-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.