Individual provider Active NPI

Thomas Carl Hall, MD

  • Dermatology Physician
  • Stillwater, OK
National Provider Identifier
1174578280
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
22869 Issued in OK
Practice address
1329 S Sangre Rd
Stillwater, OK 74074-1854
Phone
(405) 533-3376
Fax
(405) 533-1312
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 22869 OK Primary

Addresses

Primary practice location

1329 S Sangre Rd
Stillwater, OK 74074-1854

Mailing address

PO Box 1583
Stillwater, OK 74076-1500
Phone (405) 533-3376

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
I20050801001051 OK Practitioner - Dermatology 2769425941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1329 S Sangre Rd
US Dermatology Partners
Stillwater, OK 74074-1854
Phone (405) 533-3376

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as individual
Promoting interoperability
89
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision34
Removal of skin lesions2951
Removal of nail tissue1-10
Removal or shaving of skin growth12
Skin biopsy551

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Mar 23, 2018 Accepting new patients
Dermatology Associates Dermatology Past Accepting new patients

Locations

915 E Owen K Garriott Rd
Ste D
Enid, OK 73701
Phone (580) 237-1877

415 Fairview Ave
Ste 202
Ponca City, OK 74601
Phone (580) 718-4507

1908 N 14th St
Ste 207
Ponca City, OK 74601
Phone (580) 763-5900

117 Patton Dr
Ponca City, OK 74601
Phone (580) 762-7450

1329 S Sangre Rd
Stillwater, OK 74074
Phone (405) 372-7575

1212 W 12th Ave
Stillwater, OK 74074
Phone (405) 533-3376

916 19th St
Woodward, OK 73801
Phone (580) 256-2188

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1174578280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740761500",
            "telephone_number": "405-533-3376",
            "fax_number": "405-533-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 S SANGRE RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740741854",
            "telephone_number": "405-533-3376",
            "fax_number": "405-533-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "THOMAS",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "22869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.