Individual provider Active NPI

Michael Hitsman

  • Family Medicine Physician
  • Vinita, OK
National Provider Identifier
1306387907
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6419 Issued in OK
Practice address
715 N Foreman St
Vinita, OK 74301-1422
Phone
(918) 256-8731
Fax
(918) 256-8234
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 6419 OK Primary

Addresses

Primary practice location

715 N Foreman St
Vinita, OK 74301-1422

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125

Other practice location 1

26300 S Highway 125
Afton, OK 74331-6282
Phone (918) 257-8585

Other identifiers 1

IdentifierTypeStateIssuer
200800080BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240103004431 MA Practitioner - Family Practice 9931531787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Practice addresses (Care Compare)

27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000

383 S Orleans Rd
Brewster, MA 02631-2870
Phone (508) 240-3500

Hospital & facility affiliations

  • Continuum Care of Mass, LLC Hospice, Fall River, MA, CCN 221609
  • Broad Reach Hospice Hospice, Chatham, MA, CCN 221559
  • Beacon Hospice, an Amedisys Company Hospice, Charlestown, MA, CCN 221544
  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
  • Falmouth Hospital Hospital, Falmouth, MA, CCN 220135
  • Cape Cod Post Acute Care Nursing home, Brewster, MA, CCN 225667

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6419OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Physicians of Cape Cod Hospital CurrentSince Dec 29, 2023 Accepting new patients
Cherokee Nation CurrentSince Oct 31, 2019 Accepting new patients
Cherokee Nation CurrentSince Oct 31, 2019 Accepting new patients
Vytal Health Solutions LLC CurrentSince Nov 4, 2023 Accepting new patients
Warren Clinic Inc CurrentSince Jun 30, 2020 Accepting new patients
Cape Cod Operator LLC Past Accepting new patients
Cape Cod Hospital Inc Past Accepting new patients
Pleasant Bay of Brewster Rehab Center LLC Past Accepting new patients

Locations

383 S Orleans Rd
Brewster, MA 02631
Phone (508) 240-3500

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

26300 S Highway 125
Monkey Island, OK 74331
Phone (918) 257-8585

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

715 N Foreman St
Vinita, OK 74301
Phone (918) 256-8477

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1306387907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FOREMAN ST",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743011422",
            "telephone_number": "918-256-8731",
            "fax_number": "918-256-8234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26300 S Highway 125",
            "address_purpose": "LOCATION",
            "city": "Afton",
            "state": "OK",
            "postal_code": "743316282",
            "country_code": "US",
            "telephone_number": "918-257-8585",
            "fax_number": "918-257-8560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HITSMAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200800080B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

Verify at the official NPI Registry.