NPIMap

Individual provider Active NPI

Stuart Joseph Lisle, MD

  • Family Medicine Physician
  • Bethany, OK
National Provider Identifier
1447541750
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31441 Issued in OK
Practice address
7530 NW 23Rd St
Bethany, OK 73008-4921
Phone
(405) 787-8562
Fax
(405) 787-8533
NPI assigned
Apr 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 31441 OK Primary

Addresses

Primary practice location

7530 NW 23Rd St
Bethany, OK 73008-4921

Mailing address

7530 NW 23Rd St
Bethany, OK 73008-4921
Phone (405) 787-8562

Other identifiers 1

IdentifierTypeStateIssuer
31441OtherOKSTATE MEDICAL LICENSE

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
I20150730010974 OK Practitioner - Family PracticePractitioner - Sports Medicine 4486898186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

4400 Grant Blvd
Yukon, OK 73099-0037
Phone (405) 787-8550

Hospital & facility affiliations

  • Apex Home Health Home health agency, Oklahoma City, OK, CCN 377709
  • Elara Caring XX Home health agency, Oklahoma City, OK, CCN 377648
  • Integris Home Care Oklahoma City Home health agency, Oklahoma City, OK, CCN 377051
  • Community Hospital, LLC Hospital, Oklahoma City, OK, CCN 370203
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Physicians Group LLC Family Medicine CurrentSince Jul 24, 2017 Accepting new patients
Eagle Community Clinic LLC Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

7530 NW 23rd St
Bethany, OK 73008
Phone (405) 730-6990

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

4400 Grant Blvd
Yukon, OK 73099
Phone (405) 467-4440

Interoperability endpoints

  • Direct secure messaging: stuart.lisle@gilmed.eclinicaldirectplus.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 10

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1447541750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084921",
            "telephone_number": "405-787-8562",
            "fax_number": "405-787-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084921",
            "telephone_number": "405-787-8562",
            "fax_number": "405-787-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISLE",
        "first_name": "STUART",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "31441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "31441",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

Sources for this page

Verify at the official NPI Registry.