NPIMap

Individual provider Active NPI

James Lawrence Netreba, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Oklahoma City, OK
National Provider Identifier
1093940462
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD34052 Issued in OK
Practice address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone
(405) 752-3814
Fax
(512) 597-2713
NPI assigned
May 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X A107559 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A107559 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X P2744 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD34052 OK Primary

Addresses

Primary practice location

4300 W Memorial Rd
Oklahoma City, OK 73120-8304

Mailing address

PO Box 21157
Oklahoma City, OK 73156-1157
Phone (405) 752-3828

Other identifiers 2

IdentifierTypeStateIssuer
TXB154038OtherTXMEDICARE
3004194MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120628000299 TX Practitioner - Pathology 6204091077 Reassigns benefits to 1 organization
I20180912002370 OK Practitioner - Pathology 6204091077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at Houston, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Group PCGroup PAC ID 6103993167, 9 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7065

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 272-7065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.64 of 100Reported as group
Quality
71.28
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEMPORARYTXMDHematology & Oncology Physician
A107559CAMDAnatomic Pathology & Clinical Pathology Physician
MD34052OKMDAnatomic Pathology & Clinical Pathology Physician
P2744TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Pathology Associates Cytopathology CurrentSince May 31, 2015 Accepting new patients
Pathology Group PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 20, 2018 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

1122 Austin Hwy
San Antonio, TX 78209
Phone (210) 342-6488

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.

Hospital & facility affiliations 6

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": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1093940462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21157",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731561157",
            "telephone_number": "405-752-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208304",
            "telephone_number": "405-752-3814",
            "fax_number": "512-597-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETREBA",
        "first_name": "JAMES",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "A107559",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A107559",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "P2744",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "MD34052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "TXB154038",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004194",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.