NPIMap

Individual provider Active NPI

Miriam Elaine Thompson-Mathew, MD

  • Family Medicine Physician
  • Mustang, OK
National Provider Identifier
1275675662
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24609 Issued in OK
Practice address
201 S Sara Rd Ste 200
Mustang, OK 73064-4308
Phone
(405) 578-3250
Fax
(405) 578-3299
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24609 OK Primary

Addresses

Primary practice location

201 S Sara Rd Ste 200
Mustang, OK 73064-4308

Mailing address

201 S Sara Rd Ste 200
Mustang, OK 73064-4308
Phone (405) 578-3250

Other identifiers 1

IdentifierTypeStateIssuer
200194190AMedicaidOK

Other names 1

  • Dr. Miriam Elaine Thompson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000842 OK Practitioner - Family Practice 0345313284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
GDN LLCGroup PAC ID 7810236007, 11 clinicians
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1315 Chisholm Trail Pkwy
Duncan, OK 73533-1544
Phone (580) 606-6852

608 NW 9TH St
Oklahoma City, OK 73102-1049

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24609OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince Jul 5, 2012 Accepting new patients
Saints Medical Group, LLC CurrentSince Jul 1, 2008 Accepting new patients
SSM Health Care of Oklahoma, Inc. Family Medicine CurrentSince Jul 5, 2012 Accepting new patients
Saints Medical Group, LLC Family Medicine CurrentSince Jul 1, 2008 Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

201 S Sara Rd
Ste 200
Mustang, OK 73064
Phone (405) 578-3250

3400 S Douglas Blvd
Ste 200
Oklahoma City, OK 73150
Phone (405) 272-2850

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

Interoperability endpoints

  • Direct secure messaging: mthompsonmathew36940@direct-ehr-ssmhc.com
  • Direct secure messaging: met.yhw@jkp.gwaydirect.com

Organizations & group practices 8

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.

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1275675662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S SARA RD STE 200",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730644308",
            "telephone_number": "405-578-3250",
            "fax_number": "405-578-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S SARA RD STE 200",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730644308",
            "telephone_number": "405-578-3250",
            "fax_number": "405-578-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-MATHEW",
        "first_name": "MIRIAM",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200194190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "THOMPSON",
            "middle_name": "ELAINE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mustang, OK

Sources for this page

Verify at the official NPI Registry.