Individual provider Active NPI

Chandlar Maria Vazquez, MD

  • Family Medicine Physician
  • Moore, OK
National Provider Identifier
1114549201
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36911 Issued in OK
Practice address
1060 SW 4TH St
Moore, OK 73160-2494
Phone
(405) 378-5491
Fax
(405) 378-5492
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36911 OK Primary

Addresses

Primary practice location

1060 SW 4TH St
Moore, OK 73160-2494

Mailing address

1060 SW 4TH St
Moore, OK 73160-2494
Phone (405) 378-5491

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
I20230906003940 OK Practitioner - Family Practice 9638533862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2020
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)

1060 SW 4TH St
Moore, OK 73160-2494
Phone (405) 378-5491

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jun 1, 2025 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jun 1, 2025 Accepting new patients
Mercy Hospital Logan County Inc Current Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

400 S Grand St
Crescent, OK 73028
Phone (405) 282-6700

2919 S Division St
Guthrie, OK 73044
Phone (405) 282-6301

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1060 SW 4th St
Moore, OK 73160
Phone (405) 302-2661

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

Organizations & group practices 6

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": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1114549201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602494",
            "telephone_number": "405-378-5491",
            "fax_number": "405-378-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602494",
            "telephone_number": "405-378-5491",
            "fax_number": "405-378-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "CHANDLAR",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "36911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.