Individual provider Active NPI

Nicholas Twidale, M.D.,PHD.

  • Cardiovascular Disease Physician
  • Elk City, OK
National Provider Identifier
1104886209
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17189 Issued in OK
Practice address
1701 W Avenue a
Elk City, OK 73644-3901
Phone
(580) 225-6220
Fax
(580) 225-6399
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 17189 OK Primary

Addresses

Primary practice location

1701 W Avenue a
Elk City, OK 73644-3901

Mailing address

7800 NW 85TH Ter
Oklahoma City, OK 73132-3385

Other identifiers 1

IdentifierTypeStateIssuer
100103330AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ntwidale@direct.okheart.com Direct

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
I20060425000818 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 7012985484 Reassigns benefits to 1 organization
Practice locations: Elk City, OK

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohh Physicians LLCGroup PAC ID 1759392079, 132 clinicians

Practice addresses (Care Compare)

1701 W Ave a
Elk City, OK 73644-3901
Phone (580) 225-6220

Hospital & facility affiliations

  • Great Plains Regional Medical Center Hospital, Elk City, OK, CCN 370019
  • Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17189OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohh Physicians, LLC Cardiovascular Disease CurrentSince Jan 1, 2014 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Farmers Union Hospital Association Past Accepting new patients

Locations

1146 N Hills Ctr
Ada, OK 74820
Phone (580) 332-1080

1701 W Avenue A
Elk City, OK 73644
Phone (580) 225-6220

1 Wickersham St
Mangum, OK 73554
Phone (580) 782-3353

4050 W Memorial Rd
#3
Oklahoma City, OK 73120

7800 NW 85th Ter
Oklahoma City, OK 73132
Phone (405) 972-7239

Interoperability endpoints

  • Direct secure messaging: ntwidale22011@direct.okheart.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/I-7_h5bO8aC4DcrZl24eCXsg8gA1KGV3/
  • FHIR API: https://epicrp.okheart.com/Oauth2Proxy/MYCHART/api/FHIR/R4

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 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1104886209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NW 85TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W AVENUE A",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736443901",
            "telephone_number": "580-225-6220",
            "fax_number": "580-225-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWIDALE",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.,PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "17189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100103330A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntwidale@direct.okheart.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1701 W Avenue A",
            "city": "Elk City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "736443901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.