Individual provider Active NPI

Michael McCarty, M.D.

  • Anesthesiology Physician
  • Ardmore, OK
National Provider Identifier
1073580791
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
18103 Issued in OK
Practice address
2002 12TH Ave NW
Suite C
Ardmore, OK 73401-1206
Phone
(405) 272-0361
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 18103 OK Primary

Addresses

Primary practice location

2002 12TH Ave NW
Suite C
Ardmore, OK 73401-1206

Mailing address

PO Box 1983
Ardmore, OK 73402-1983

Other identifiers 1

IdentifierTypeStateIssuer
100118920AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040524000915 OK Practitioner - Anesthesiology 2860483161 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18103OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma City Anesthesia, LLC Anesthesiology CurrentSince Mar 1, 2015 Accepting new patients
Anesthesia Medical Professionals, PLLC Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Southern Oklahoma Surgical Center Inc Past Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

11200 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 936-1000

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

4317 W Memorial Rd
Oklahoma City, OK 73134
Phone (405) 755-6240

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1073580791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1983",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734021983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "SUITE C",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011206",
            "telephone_number": "405-272-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "18103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100118920A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.