Max Carlisle (NPI# 1205839685, PAC ID# 3072695485) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1205839685 |
| PAC ID by PECOS | 3072695485 |
| Professional Enrollment ID | I20080124000177 |
| Full Name | Max Carlisle |
| Organization Legal Name | MAX CARLISLE OD PC |
| Address |
111 E Broadway Fairview OK 73737-2124 |
| Phone Number | 5802274878 |
| Gender | M |
| Medical School | UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY |
| Graduation Year | 1980 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 5496837957 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 111 E Broadway, Fairview, OK 73737-2124 | 5802274878 | MAX CARLISLE OD PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | |
| MIPS_EC_117_overall | Diabetes: Eye Exam | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Organization Legal Name | MAX CARLISLE OD PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake Carlisle | Optometry | Max Carlisle Od PC | 111 E Broadway, Fairview, OK 73737-2124 |
| Street Address |
111 E BROADWAY |
| City | FAIRVIEW |
| State | OK |
| Zip | 73737-2124 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake Carlisle | Optometry | Max Carlisle Od PC | 111 E Broadway, Fairview, OK 73737-2124 |
| Steven D Hortness | Chiropractic | 111 E Broadway, Little Falls, MN 56345-3038 | |
| Eric Dean Schultz | Physical Therapy | 111 E Broadway, Suite 340, Columbia, MO 65203-4208 | |
| Bret S Derrick | Physical Therapy | Broadway Ergonomics LLC | 111 E Broadway, Suite 340, Columbia, MO 65203-4208 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Kimball | Nurse Practitioner | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| John Stephen Price | Family Medicine | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| Jerry D Braziel | Physician Assistant | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| Donald R Klinger | Family Practice | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| Megan L Ewing | Nurse Practitioner | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| John A Hensley | Family Practice | Fairview Regional Medical Center Authority | 523 E State Rd, Fairview Regional Medical Center, Fairview, OK 73737-1453 |
| Justin Keen | Chiropractic | 301 W Elm St, Fairview, OK 73737-1618 | |
| John B Eitzen | Chiropractic | 123 W Broadway, Advanced Chiropratic Center, Fairview, OK 73737-2009 |
| City | FAIRVIEW |
| Zip Code | 73737 |
| Specialty | OPTOMETRY |
| City + Specialty | FAIRVIEW + OPTOMETRY |
Please comment or provide details below to improve the information on Max Carlisle.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.