Individual provider Active NPI

Daniel Pappas, M.D.

  • Psychiatry Physician
  • Edmond, OK
National Provider Identifier
1053762807
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
39020000X Issued in OK
Practice address
15225 Fairview Farm Rd.
Edmond, OK 73013
Phone
(405) 627-5837
NPI assigned
Jun 23, 2016
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 39020000X OK Primary

Addresses

Primary practice location

15225 Fairview Farm Rd.
Edmond, OK 73013

Mailing address

15225 Fairview Farm Rd
Edmond, OK 73013-1328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201007001328 IL Practitioner - Psychiatry 6406275627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39020000XOKMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 27, 2023 Accepting new patients
Edward Health Ventures CurrentSince Oct 2, 2020 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Edward Health Ventures CurrentSince Oct 2, 2020 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

9697 191st St
Ste 100
Mokena, IL 60448
Phone (630) 646-6540

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1053762807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 FAIRVIEW FARM RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 FAIRVIEW FARM RD.",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-627-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "39020000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.