NPIMap

Individual provider Active NPI

Patrick Earl Stout, MD

  • Urology Physician
  • Miami, OK
National Provider Identifier
1366415234
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
19779 Issued in OK
Practice address
310 2ND Ave SW
Ste. 208
Miami, OK 74354-6743
Phone
(918) 540-7870
Fax
(918) 540-7394
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 19779 OK Primary

Addresses

Primary practice location

310 2ND Ave SW
Ste. 208
Miami, OK 74354-6743

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (918) 540-7870

Other identifiers 4

IdentifierTypeStateIssuer
200468380SMedicaidOK
100044840AMedicaidOK
100270540AMedicaidKS
208578401MedicaidMO

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
I20091205000199 OK Practitioner - Urology 7315086261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wright State University Boonshoft School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

310 2ND Ave SW
208 Integris Srgns Clin
Miami, OK 74354-6702
Phone (918) 540-7870

Hospital & facility affiliations

  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Oct 1, 2013 Accepting new patients
Integris Miami Hospital Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

310 2nd Ave SW
Ste 208
Miami, OK 74354
Phone (918) 540-7655

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Interoperability endpoints

  • Direct secure messaging: pstout17281@direct.integrisok.com

Organizations & group practices 3

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1366415234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "918-540-7870",
            "fax_number": "918-540-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 2ND AVE SW",
            "address_2": "STE. 208",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546743",
            "telephone_number": "918-540-7870",
            "fax_number": "918-540-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "PATRICK",
        "middle_name": "EARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "19779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468380S",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100044840A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270540A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208578401",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.