Individual provider Active NPI

Stephen C. Dobratz, M.D.

  • Interventional Cardiology Physician
  • Russellville, AR
National Provider Identifier
1023011194
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
E-11638 Issued in AR
Practice address
2205 W Main St
Russellville, AR 72801-2759
Phone
(479) 968-4311
Fax
(479) 968-4399
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 19731 OK
Interventional Cardiology Physician 207RI0011X 19731 OK
Interventional Cardiology Physician 207RI0011X E-11638 AR Primary

Addresses

Primary practice location

2205 W Main St
Russellville, AR 72801-2759

Mailing address

2205 W Main St
Russellville, AR 72801-2759
Phone (479) 968-2345

Other identifiers 1

IdentifierTypeStateIssuer
100031210AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090608000428 OK Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0648253237 Reassigns benefits to 2 organizations
I20210106002048 TX Practitioner - Cardiovascular Disease (Cardiology) 0648253237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Eastern Virginia Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

1001 S 41St St E
Three Rivers Health Center
Muskogee, OK 74403-6253
Phone (918) 687-0201

101 S Moore Ave
Claremore, OK 74017-5047
Phone (539) 234-1000

1020 Lenape Dr
Nowata, OK 74048-4403
Phone (918) 273-0192

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

27371 S 4410 Rd
Vinita, OK 74301-7953
Phone (918) 256-4800

859 E Melton Dr
Sam Hider Health Center
Jay, OK 74346-0001
Phone (918) 253-4271

900 N Owen Walters Boulevard
A Mo Health Center
Salina, OK 74365-5003
Phone (918) 434-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting33
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Health System CurrentSince Feb 15, 2021 Accepting new patients
Cherokee Nation CurrentSince Dec 23, 2020 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Northeastern Health System CurrentSince Feb 15, 2021 Accepting new patients
Northeastern Health System Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Dec 23, 2020 Accepting new patients
Cherokee Nation Current Accepting new patients
Ahs Oklahoma Heart LLC CurrentSince Sep 1, 2011 Accepting new patients
Tahlequah Medical Group LLC Past Accepting new patients
Northeastern Health System Past Accepting new patients
Integris Cardiovascular Physicians LLC Cardiovascular Disease Past Accepting new patients
South Tulsa Medical Group LLC Past Accepting new patients
Center for Cardiovascular Medicine Cardiovascular Disease PastSince Jul 15, 1998 Accepting new patients
St Marys Physician Services, LLC Interventional Cardiology Past Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

1373 E Boone St
Ste 3400
Tahlequah, OK 74464
Phone (918) 456-9500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

Dept 1218
Tulsa, OK 74182

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: sdobratz112786@ahs.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 17

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1023011194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012759",
            "telephone_number": "479-968-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012759",
            "telephone_number": "479-968-4311",
            "fax_number": "479-968-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRATZ",
        "first_name": "STEPHEN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "19731",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OK",
            "license": "19731",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "E-11638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100031210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.