Active NPI
Michael D Elder, MD
- Anesthesiology Physician
- Oklahoma City, OK
National Provider Identifier
1255375762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 14210
- Practice address
- 4317 W Memorial Rd
Oklahoma City, OK 73134-1720 - Phone
- (405) 755-6240
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 14210 | OK | Primary |
Addresses
Primary practice location
4317 W Memorial Rd
Oklahoma City, OK 73134-1720
Mailing address
PO Box 5733
Edmond, OK 73083-5733
Phone (405) 775-9350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100106980A | 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 |
|---|---|---|---|
| 14210 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bart J. Borsky, MD, PC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Oklahoma City, OK
- NPI 1205193265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1255375762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5733",
"city": "EDMOND",
"state": "OK",
"postal_code": "730835733",
"telephone_number": "405-775-9350",
"fax_number": "405-775-9360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4317 W MEMORIAL RD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731341720",
"telephone_number": "405-755-6240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "14210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100106980A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.