Individual provider Active NPI

Michael Cooper, D.O.

  • Family Medicine Physician
  • Claremore, OK
National Provider Identifier
1336109727
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12946 Issued in OK
Practice address
3100 Medical Pkwy
100
Claremore, OK 74017-1088
Phone
(918) 341-1000
Fax
(918) 293-3141
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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 12946 OK Primary

Addresses

Primary practice location

3100 Medical Pkwy
100
Claremore, OK 74017-1088

Mailing address

1515 N Harvard Ave
Suite E
Tulsa, OK 74115-4957
Phone (918) 832-6049

Other identifiers 1

IdentifierTypeStateIssuer
100119730AMedicaidOK

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
I20110107000142 OK Practitioner - Family Practice 2961691845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2967

Hospital & facility affiliations

  • Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12946OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc Family Medicine CurrentSince Jun 1, 1995 Accepting new patients

Locations

1910 S Falcon Ave
Claremore, OK 74019
Phone (918) 341-1000

3100 Medical Pkwy
#100
Claremore, OK 74017
Phone (844) 372-0087

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1515 N Harvard Ave
Ste E
Tulsa, OK 74115
Phone (918) 832-6049

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.

Hospital & facility affiliations 7

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1336109727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N HARVARD AVE",
            "address_2": "SUITE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741154957",
            "telephone_number": "918-832-6049",
            "fax_number": "918-832-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MEDICAL PKWY",
            "address_2": "100",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740171088",
            "telephone_number": "918-341-1000",
            "fax_number": "918-293-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "12946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100119730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.