NPIMap

Individual provider Active NPI

Mark Edwin Rathgeber, M.D.

  • Psychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1114090248
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16229 Issued in OK
Practice address
701 Market Dr
Oklahoma City, OK 73114
Phone
(405) 951-3719
Fax
(405) 951-3916
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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 16229 OK Primary

Addresses

Primary practice location

701 Market Dr
Oklahoma City, OK 73114

Mailing address

701 Market Dr
Oklahoma City, OK 73114
Phone (405) 951-3719

Other identifiers 1

IdentifierTypeStateIssuer
100200890AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120417000672 TX Practitioner - Psychiatry 4789878422 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

701 Market Dr
Oklahoma City, OK 73114-8132
Phone (405) 931-3833

Hospital & facility affiliations

  • Lawton Indian Hospital Hospital, Lawton, OK, CCN 370170

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawton Indian Hospital CurrentSince Feb 26, 2012 Accepting new patients
Dept of Health and Human Services PHS Indian Health Service CurrentSince Oct 1, 2019 Accepting new patients
Clinton Indian Health Center CurrentSince Dec 1, 2012 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
Northwest Center for Behavioral Health PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients
State of Oklahoma PastSince Jul 8, 2010 Accepting new patients

Locations

201 E Parker McKenzie Dr
Anadarko, OK 73005
Phone (405) 247-7900

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

701 Market Dr
Oklahoma City, OK 73114
Phone (405) 931-3833

Organizations & group practices 12

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1114090248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MARKET DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73114",
            "telephone_number": "405-951-3719",
            "fax_number": "405-951-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MARKET DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73114",
            "telephone_number": "405-951-3719",
            "fax_number": "405-951-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHGEBER",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "16229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.