Individual provider Active NPI

Myles Fisher, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1407208333
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0132R Issued in OK
Practice address
4200 S Douglas Ave
Suite 306
Oklahoma City, OK 73109-3223
Phone
(405) 636-7000
NPI assigned
Jul 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 0132R OK Primary

Addresses

Primary practice location

4200 S Douglas Ave
Suite 306
Oklahoma City, OK 73109-3223

Mailing address

1012 SW 140TH St
Oklahoma City, OK 73170-4306
Phone (510) 326-6078

Other identifiers 1

IdentifierTypeStateIssuer
0132ROtherOKOSBOE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200810001254 CA Practitioner - Emergency Medicine 7911273107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0132ROKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jan 22, 2023 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Sep 15, 2021 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 27, 2022 Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince Jan 27, 2022 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: mfisher590499@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 3

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": "1467504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1407208333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 SW 140TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704306",
            "telephone_number": "510-326-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S DOUGLAS AVE",
            "address_2": "SUITE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093223",
            "telephone_number": "405-636-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MYLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-03",
        "last_updated": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0132R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSBOE",
            "identifier": "0132R",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "250 Hospital Pkwy",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.