Individual provider Active NPI

Michael Lundberg, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1366865206
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0009R Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 636-7000
NPI assigned
Jan 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0009R OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20170710001389 NV Practitioner - Emergency Medicine 2365663713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fremont Emergency Services Scherr LTDGroup PAC ID 4880684554, 135 clinicians

Practice addresses (Care Compare)

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (856) 686-4394

Hospital & facility affiliations

  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5589OKMDDentist
0009ROKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Past Accepting new patients

Locations

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

9075 Blue Diamond Rd
Las Vegas, NV 89178
Phone (702) 916-5000

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

10770 Las Vegas Blvd S
Las Vegas, NV 89183
Phone (702) 916-9002

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

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.

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": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1366865206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0009R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.