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Individual provider Active NPI

Bernard Michael Tougas Jr., D.C, P.A.-C

  • Physician Assistant
  • Roland, OK
National Provider Identifier
1366434680
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1536 Issued in OK
Practice address
205 E Ray Fine Blvd
Roland, OK 74954-5181
Phone
(918) 503-6235
NPI assigned
Aug 22, 2005
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1536 OK Primary
Chiropractor 111N00000X 1462 AR
Chiropractor 111N00000X 3388 OK

Addresses

Primary practice location

205 E Ray Fine Blvd
Roland, OK 74954-5181

Mailing address

PO Box 5437
Fort Smith, AR 72913-5437
Phone (918) 503-5235

Other identifiers 2

IdentifierTypeStateIssuer
146137718MedicaidAR
621705485OtherARPRIVATE INSURES

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
I20240109002585 OK Practitioner - Family Practice 1951322635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Medicine and Surgery, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Poteau, OK 74953

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1462ARMDChiropractor
3388OKMDChiropractor
1536OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leflore County Hospital Authority CurrentSince Nov 26, 2023 Accepting new patients
Leflore County Hospital Authority CurrentSince Nov 26, 2023 Accepting new patients
St. Madron Medical Clinic Past Accepting new patients
Leflore County Hospital Authority Past Accepting new patients
United Pain Care Fort Smith Past Accepting new patients
Terry Brackman DO Inc. PastSince Jan 1, 1990 Accepting new patients
Tougas Chiropractic Clinic Chiropractor Past Accepting new patients

Locations

104 Wall St
Poteau, OK 74953
Phone (918) 635-3578

105 Wall St
Poteau, OK 74953
Phone (918) 635-3100

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1366434680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5437",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729135437",
            "telephone_number": "918-503-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E RAY FINE BLVD",
            "city": "ROLAND",
            "state": "OK",
            "postal_code": "749545181",
            "telephone_number": "918-503-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOUGAS",
        "first_name": "BERNARD",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "D.C, P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1536",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1462",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146137718",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURES",
            "identifier": "621705485",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roland, OK

Sources for this page

Verify at the official NPI Registry.