Individual provider Active NPI

Merle Basquez

  • Physical Therapist
  • Muskogee, OK
National Provider Identifier
1306954078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3308 W Okmulgee St
Muskogee, OK 74401-5069
Phone
(918) 683-7731
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3308 W Okmulgee St
Muskogee, OK 74401-5069

Mailing address

21092 E 102ND St
Broken Arrow, OK 74014-3617
Phone (918) 449-0503

Other identifiers 1

IdentifierTypeStateIssuer
2106OtherOKLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130201000392 OK Practitioner - Physical Therapist in Private Practice 8123038700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings Inc 1,992 clinicians

Practice addresses (Care Compare)

1010 Garth Brooks Blvd
Suite 135
Yukon, OK 73099-4194
Phone (405) 350-2000

8110 S Yale Ave
Suite 201
Tulsa, OK 74137-2294
Phone (539) 235-0170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2106OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Jul 19, 2004 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Jul 19, 2004 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Physical Therapy Services of Bartlesville Inc Physical Therapist PastSince Sep 13, 1995 Accepting new patients

Locations

1010 Garth Brooks Blvd
Ste 135
Yukon, OK 73099
Phone (405) 350-2000

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306954078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21092 E 102ND ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740143617",
            "telephone_number": "918-449-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015069",
            "telephone_number": "918-683-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASQUEZ",
        "first_name": "MERLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "2106",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.