NPIMap

Individual provider Active NPI

Jesse P Pandian, DO

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1174145767
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7312 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 636-7000
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OK
Emergency Medicine Physician 207P00000X 7312 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

8736 Yassir Blvd
Yukon, OK 73099-3584
Phone (918) 398-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20220510002367 OK Practitioner - Emergency Medicine 9830576909 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Emergency Services, PCGroup PAC ID 8224212949, 57 clinicians

Practice addresses (Care Compare)

200 2ND Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7312OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Farmers Union Hospital Association Current Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
Grady Memorial Hospital CurrentSince Jun 1, 2022 Accepting new patients
Farmers Union Hospital Association CurrentSince Apr 20, 2022 Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Integris Grove Hospital Past Accepting new patients
Integris Miami Hospital Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

1800 W 1st St
Ste 3
Elk City, OK 73644
Phone (580) 225-4699

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

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

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

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 10

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 5

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": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1174145767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8736 YASSIR BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993584",
            "telephone_number": "918-398-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDIAN",
        "first_name": "JESSE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.