Individual provider Active NPI

Marion K. Studebaker, M.D.

  • Family Medicine Physician
  • Yukon, OK
National Provider Identifier
1306875729
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13434 Issued in OK
Practice address
520 S Mustang Rd
Yukon, OK 73099-6737
Phone
(405) 936-5910
Fax
(405) 577-2605
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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 13434 OK Primary

Addresses

Primary practice location

520 S Mustang Rd
Yukon, OK 73099-6737

Mailing address

520 S Mustang Rd
Yukon, OK 73099-6737
Phone (405) 936-5910

Other identifiers 4

IdentifierTypeStateIssuer
13434OtherOKLICENSE
100088380AMedicaidOK
080020799OtherOKRAILROAD
20466OtherOKOBNDD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20041105000983 OK Practitioner - Family Practice 9638132194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

520 S Mustang Rd
Yukon, OK 73099-6737
Phone (405) 936-5910

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Family Medicine CurrentSince Jan 1, 2011 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

520 S Mustang Rd
Yukon, OK 73099
Phone (405) 256-6653

Interoperability endpoints

  • Direct secure messaging: mstudebaker17243@directc.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1306875729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996737",
            "telephone_number": "405-936-5910",
            "fax_number": "405-577-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996737",
            "telephone_number": "405-936-5910",
            "fax_number": "405-577-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDEBAKER",
        "first_name": "MARION",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "13434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "13434",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088380A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "080020799",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBNDD",
            "identifier": "20466",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.