Muskogee Medical and Surgical Associates, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MUSKOGEE MEDICAL AND SURGICAL ASSOCIATES, LLC

Practice address

3520 Chandler Rd
Muskogee, OK 74403-4910

Phone

(918) 682-0721

NPI assigned

May 4, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Daniel S. Slipkovich

Title

Ceo

Phone

(615) 764-3000

Specialties & licenses 6

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2065/brand/5/csg/1/fhir/r4

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Noel Evans, M.D.

  • Family Medicine Physician
  • Porter, OK
  • NPI 1003850132
  NPD (past)
• Timothy Charles Hoekstra, MD

  • Obstetrics & Gynecology Physician
  • Ponca City, OK
  • NPI 1902862600
  NPD (past)
• Luis Alexander Frias Mendoza

  • Neurology Physician
  • Frederiksted, VI
  • NPI 1982710117
  NPD (past)
• Diederik Frederik Meursing, M.D.

  • Family Medicine Physician
  • Fitchburg, MA
  • NPI 1073664033
  NPD (past)
• Michael Wayne Rosenberg, M.D.

  • Surgery Physician
  • Tampa, FL
  • NPI 1932213865
  NPD (past)

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1184858375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CORPORATE CENTRE DR",
            "address_2": "SUITE 200",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672659",
            "telephone_number": "615-764-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 CHANDLER RD",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034910",
            "telephone_number": "918-682-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSKOGEE MEDICAL AND SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "SLIPKOVICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-764-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "OKB5634",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muskogee Foot Clinic Inc.
• Muskogee Health Services LLC
• Muskogee Heart Center, Inc.
• Muskogee Immediate Care Inc
• Muskogee Medical & Surgical Associates LLC
• Muskogee Medical Care PLLC
• Muskogee Medical Group PLLC (Muskogee Surgical Group)
• Muskogee Medical Group, LLC
• Muskogee Medical Inc
• Muskogee Pediatric Dental PLLC

• Family Medicine Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.