Organization Active NPI

Craige M. Brestel, M.D. PLLC

  • Obstetrics & Gynecology Physician
  • Muskogee, OK
National Provider Identifier
1225298979
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
19912 Issued in OK
Legal business name
CRAIGE M. BRESTEL, M.D. PLLC
Practice address
3502 West Broadway Street
Muskogee, OK 74401
Phone
(918) 687-5477
Fax
(918) 687-0684
NPI assigned
Jun 16, 2008
Last updated
Jul 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Authorized official

Name
Dr. Craige Montane Brestel, MDNPI 1497762280
Title
Sole Member
Phone
(918) 687-5477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 19912 OK Primary

Addresses

Primary practice location

3502 West Broadway Street
Muskogee, OK 74401

Mailing address

3502 West Broadway Street
Muskogee, OK 74401
Phone (918) 687-5477

Other identifiers 2

IdentifierTypeStateIssuer
200317890BMedicaidOK
200317890AMedicaidOK

Other names 1

  • Muskogee Women's Clinic Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110923000573 OK Part B Supplier - Clinic/Group Practice 6507037421 Receives reassigned benefits from 1 practitioner
Practice locations: Muskogee, OK; Talequah, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2021694Craige M Brestel, MD, PLLC3502 West Broadway, Muskogee, OK 74401Certificate of waiverAug 28, 2026

National Provider Directory

National Provider Directory

Locations

2900 N Main St
Muskogee, OK 74401
Phone (918) 300-1320

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1225298979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 WEST BROADWAY STREET",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-687-5477",
            "fax_number": "918-687-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 WEST BROADWAY STREET",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-687-5477",
            "fax_number": "918-687-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIGE M. BRESTEL, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "BRESTEL",
        "authorized_official_first_name": "CRAIGE",
        "authorized_official_middle_name": "MONTANE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "918-687-5477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "19912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200317890B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200317890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muskogee Women's Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.