Individual provider Active NPI

Michael Leo Winzenread, M.D.

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1386668358
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11950 Issued in OK
Practice address
16400 N May Ave
Edmond, OK 73013-8971
Phone
(405) 471-6800
Fax
(405) 471-6811
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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 11950 OK Primary

Addresses

Primary practice location

16400 N May Ave
Edmond, OK 73013-8971

Mailing address

16400 N May Ave
Edmond, OK 73013-8971
Phone (405) 471-6800

Other identifiers 1

IdentifierTypeStateIssuer
100129340AMedicaidOK

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
I20100329000041 OK Practitioner - Family Practice 2567598659 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11950OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Aug 21, 2015 Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince Aug 21, 2015 Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Summit Medical Center Past Accepting new patients
Deaconess Physician Services LLC Family Medicine Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

Organizations & group practices 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1386668358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 N MAY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138971",
            "telephone_number": "405-471-6800",
            "fax_number": "405-471-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 N MAY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138971",
            "telephone_number": "405-471-6800",
            "fax_number": "405-471-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINZENREAD",
        "first_name": "MICHAEL",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "11950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100129340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.