NPIMap

Individual provider Active NPI

Michael Dean Hartwig, MD

  • Family Medicine Physician
  • Perry, OK
National Provider Identifier
1457354201
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16159 Issued in OK
Practice address
505 N 14TH St
Perry, OK 73077-5021
Phone
(580) 336-3529
Fax
(580) 336-2409
NPI assigned
May 24, 2005
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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 16159 OK Primary

Addresses

Primary practice location

505 N 14TH St
Perry, OK 73077-5021

Mailing address

505 N 14TH St
Ste C
Perry, OK 73077-5000
Phone (580) 336-3529

Other identifiers 2

IdentifierTypeStateIssuer
731341903OtherOKTAX ID
100106450AMedicaidOK

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
I20100730000331 OK Practitioner - Family Practice 5395878193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770

501 N 14TH St
Perry Specialty Clinic
Perry, OK 73077-5021
Phone (580) 336-5577

505 N 14TH St
Perry Family Physicians
Perry, OK 73077-5021
Phone (580) 336-3537

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16159OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Stillwater Medical Center Authority Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Hospital Care Consultants Region II Inc CurrentSince Jan 25, 2012 Accepting new patients
Perry Green Valley Nursing Home LLC Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Physicians Family Medicine Past Accepting new patients

Locations

1801 W 3rd St
Elk City, OK 73644
Phone 40584358551407

501 N 14th St
Perry, OK 73077
Phone (580) 336-3541

505 N 14th St
Perry, OK 73077
Phone (580) 336-2209

505 N 14th St
Ste C
Perry, OK 73077
Phone (580) 336-3529

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

17304 Preston Rd
Ste 1400
Dallas, TX 75252
Phone (972) 934-3200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: michael.hartwig.1@9147.direct.athenahealth.com
  • Direct secure messaging: michael.hartwig.p1@direct.smc.nextgenshare.com

Organizations & group practices 7

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 8

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1457354201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N 14TH ST",
            "address_2": "STE C",
            "city": "PERRY",
            "state": "OK",
            "postal_code": "730775000",
            "telephone_number": "580-336-3529",
            "fax_number": "580-336-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N 14TH ST",
            "city": "PERRY",
            "state": "OK",
            "postal_code": "730775021",
            "telephone_number": "580-336-3529",
            "fax_number": "580-336-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "731341903",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, OK

Sources for this page

Verify at the official NPI Registry.