Active NPI
Stephen Carlos Medina, MD
- Gastroenterology Physician
- Claremore, OK
National Provider Identifier
1235182650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 20083
- Practice address
- 1501 N Florence Ave Ste 250
Claremore, OK 74017-3256 - Phone
- (918) 343-8513
- Fax
- (918) 341-7090
- NPI assigned
- May 18, 2006
- Last updated
- May 3, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 20083 | OK | Primary |
Addresses
Primary practice location
1501 N Florence Ave Ste 250
Claremore, OK 74017-3256
Mailing address
1501 N Florence
Ste 250
Claremore, OK 74017-3256
Phone (918) 343-8513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100215260A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20083 | OK | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Claremore Internal Medicine, LLC | Past | Accepting new patients | |
| Radiation Oncology Services Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Claremore, OK
- NPI 1659314011
-
- Radiation Oncology Physician
- Tulsa, OK
- NPI 1861431611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399075200000",
"number": "1235182650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 N FLORENCE",
"address_2": "STE 250",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740173256",
"telephone_number": "918-343-8513",
"fax_number": "918-341-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N FLORENCE AVE STE 250",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740173256",
"telephone_number": "918-343-8513",
"fax_number": "918-341-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "STEPHEN",
"middle_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2014-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OK",
"license": "20083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100215260A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Claremore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.