Individual provider Active NPI

Andrew Michael Vitale, M.D.

  • Urology Physician
  • Oklahoma City, OK
National Provider Identifier
1114311271
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
40720 Issued in OK
Practice address
4200 W Memorial Rd Ste 901
Oklahoma City, OK 73120-8378
Phone
(405) 749-4230
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 40720 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd Ste 901
Oklahoma City, OK 73120-8378

Mailing address

4200 W Memorial Rd Ste 901
Oklahoma City, OK 73120-8378
Phone (405) 749-4230

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
I20230227000160 OK Practitioner - Urology 9436429420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4140 W Memorial Rd
Suite 208
Oklahoma City, OK 73120-8300
Phone (405) 755-4290

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection20
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Feb 27, 2023 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4140 W Memorial Rd
Ste 208
Oklahoma City, OK 73120
Phone (405) 749-4230

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

4200 W Memorial Rd
Ste 901
Oklahoma City, OK 73120
Phone (405) 242-4030

Organizations & group practices 2

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 3

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1114311271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD STE 901",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208378",
            "telephone_number": "405-749-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD STE 901",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208378",
            "telephone_number": "405-749-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "40720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.