Individual provider Active NPI

Max Cieminski, DO

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1194734616
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2852 Issued in OK
Practice address
5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone
(405) 842-4464
Fax
(405) 841-5905
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2852 OK Primary

Addresses

Primary practice location

5501 N Portland Ave
Oklahoma City, OK 73112-2074

Mailing address

6430 N Western Ave
Oklahoma City, OK 73116-7322
Phone (405) 841-5905

Other identifiers 1

IdentifierTypeStateIssuer
100090840AMedicaidOK

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
I20120316000518 OK Practitioner - Anesthesiology 4981863511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Oklahoma State University College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Anesthesia Services, LLCGroup PAC ID 0042587842, 21 clinicians
Portland Anesthesia Services LLCGroup PAC ID 8224512512, 21 clinicians

Practice addresses (Care Compare)

5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone (405) 604-6000

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2852OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma City Anesthesia, LLC Anesthesiology CurrentSince Mar 1, 2016 Accepting new patients
Deaconess Anesthesia Services LLC Anesthesiology CurrentSince May 15, 2017 Accepting new patients
Emergency Physician Associates of Maryland, P.C. Past Accepting new patients
Richard J Langerman, D.O., P.C. Anesthesiology Past Accepting new patients

Locations

6430 N Western Ave
Oklahoma City, OK 73116
Phone (405) 841-5905

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

5401 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-4160

Organizations & group practices 5

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1194734616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 N WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167322",
            "telephone_number": "405-841-5905",
            "fax_number": "405-840-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122074",
            "telephone_number": "405-842-4464",
            "fax_number": "405-841-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIEMINSKI",
        "first_name": "MAX",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "2852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090840A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.