Individual provider Active NPI

Mark Edsall Michels, MD

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1114457017
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33113 Issued in OK
Practice address
900 NE 10TH St # 2102
Oklahoma City, OK 73104-5420
Phone
(405) 271-2230
NPI assigned
Jun 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33113 OK Primary

Addresses

Primary practice location

900 NE 10TH St # 2102
Oklahoma City, OK 73104-5420

Mailing address

2022 24TH Ave SE
Norman, OK 73071-1006
Phone (580) 886-5171

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
I20210121002664 OK Practitioner - HospitalistPractitioner - Family Practice 7214208412 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McCurtain Memorial Medical Management, Inc. Emergency Medicine CurrentSince Sep 30, 2020 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Aug 13, 2021 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Aug 13, 2021 Accepting new patients
McCurtain Memorial Medical Management, Inc. CurrentSince Sep 30, 2020 Accepting new patients
McCurtain Memorial Medical Management, Inc. Current Accepting new patients
Integris Bass Baptist Health Center Past Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients

Locations

1301 E Lincoln Rd
Idabel, OK 74745
Phone (580) 208-3103

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1500 N Green Ave
Purcell, OK 73080
Phone (405) 527-2250

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1114457017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 24TH AVE SE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730711006",
            "telephone_number": "580-886-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 10TH ST # 2102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045420",
            "telephone_number": "405-271-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELS",
        "first_name": "MARK",
        "middle_name": "EDSALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "33113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.