Individual provider Active NPI

Jerome Anthony McTague, MD, JD

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1194758540
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
30495 Issued in OK
Practice address
2200 N Classen Blvd
Suite 1403
Oklahoma City, OK 73106-5800
Phone
(419) 461-1057
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30495 OK Primary
Emergency Medicine Physician 207P00000X 2014015848 MO

Addresses

Primary practice location

2200 N Classen Blvd
Suite 1403
Oklahoma City, OK 73106-5800

Mailing address

2200 N Classen Blvd
Suite 1403
Oklahoma City, OK 73106-5800
Phone (419) 461-1057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150303001199 OK Practitioner - Emergency Medicine 9234193236 Reassigns benefits to 6 organizations
I20150501000537 MO Practitioner - Emergency Medicine 9234193236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Washington University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehp of Ponca City LLCGroup PAC ID 1850828948, 21 clinicians
Elite Hospital Partners of OklahomaGroup PAC ID 6800241225, 24 clinicians
Ies Oklahoma LLCGroup PAC ID 2769824937, 16 clinicians

Practice addresses (Care Compare)

1900 N 14TH St
Ponca City, OK 74601-2035
Phone (580) 765-3321

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (254) 879-4900

5602 SW Lee Blvd
Lawton, OK 73505-9635
Phone (580) 531-4700

Hospital & facility affiliations

  • Integris Health Ponca City Hospital, Ponca City, OK, CCN 370006
  • Memorial Health Hospital, Lawton, OK, CCN 370056

Merit-based Incentive Payment System (MIPS)

Final score
95.39 of 100Reported as individual
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Juris Doctor, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30495OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Feb 27, 2015 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Ies Oklahoma LLC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Memorial Hospital Current Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Feb 27, 2015 Accepting new patients
Physicians Choice Hospital - Fremont Physicians Current Accepting new patients
Ehp of Ponca City LLC Emergency Medicine CurrentSince Nov 18, 2024 Accepting new patients
Nes Oklahoma, Inc. Emergency Medicine CurrentSince Oct 15, 2019 Accepting new patients
Erie Emergency Physicians, Inc. Emergency Medicine Past Accepting new patients
Lucas County Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Memorial Emergency Specialists Inc. Emergency Medicine PastSince Oct 1, 2006 Accepting new patients
Fort Ball Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients
Integris Health Ponca City Hospital Inc Past Accepting new patients
Mercy Emergency Care Services, Inc. Emergency Medicine Past Accepting new patients
Ohio Em-I Medical Services Professional Association Emergency Medicine Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321

2390 Enterprise St
Fremont, OH 43420
Phone (419) 461-1057

1415 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-6657

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

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 19

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.

View all 19

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1194758540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N CLASSEN BLVD",
            "address_2": "SUITE 1403",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731065800",
            "telephone_number": "419-461-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N CLASSEN BLVD",
            "address_2": "SUITE 1403",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731065800",
            "telephone_number": "419-461-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCTAGUE",
        "first_name": "JEROME",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD, JD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "30495",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2014015848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.