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Individual provider Active NPI

Christopher S Deloache, D.O.

  • Orthopaedic Surgery Physician
  • Tahlequah, OK
National Provider Identifier
1104832179
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3349 Issued in OK
Practice address
1373 E. Boone St.
Suite 3401
Tahlequah, OK 74464-3234
Phone
(918) 456-6848
Fax
(918) 456-1150
NPI assigned
Jul 31, 2006
Last updated
Sep 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3349 OK Primary

Addresses

Primary practice location

1373 E. Boone St.
Suite 3401
Tahlequah, OK 74464-3234

Mailing address

1373 E. Boone St.
Suite 3401
Tahlequah, OK 74464-3234
Phone (918) 456-6848

Other identifiers 1

IdentifierTypeStateIssuer
100256650BMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000670 OK Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Pain Management 3173426996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pain Management, Sports Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1373 E Boone St
Suite 3401
Tahlequah, OK 74464-3365
Phone (918) 456-6848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.23 of 100Reported as individual
Quality
93.01
Improvement activities
40
Cost
92.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement26
Lower limb (leg) arthroscopy (minimally invasive joint repair)12
Upper limb (arm) arthroscopy (minimally invasive joint repair)92
Removal of tissue43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3349OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tahlequah Orthopedic Surgery Services, LLC Orthopaedic Surgery CurrentSince Oct 28, 2003 Accepting new patients
Northeastern Health System Past Accepting new patients
Summit Medical Center Past Accepting new patients
Northeastern Health System Past Accepting new patients

Locations

1373 E Boone St
Ste 3401
Tahlequah, OK 74464
Phone (918) 456-6848

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

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.

Hospital & facility affiliations 7

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1104832179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 E. BOONE ST.",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643234",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 E. BOONE ST.",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643234",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACHE",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "3349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256650B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.