Individual provider Active NPI

Dana J Bock, MD

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1487614285
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
17379 Issued in OK
Practice address
11200 N Portland Ave
Oklahoma City, OK 73120-5045
Phone
(405) 272-9644
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 17379 OK Primary

Addresses

Primary practice location

11200 N Portland Ave
Oklahoma City, OK 73120-5045

Mailing address

3333 NW 63Rd St Ste 106
Oklahoma City, OK 73116-3710
Phone (405) 296-3270

Other identifiers 1

IdentifierTypeStateIssuer
100090470AMedicaidOK

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
I20101018000144 OK Practitioner - Anesthesiology 7618160144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma City Anesthesia, LLCGroup PAC ID 5597705335, 2 clinicians

Practice addresses (Care Compare)

11200 N Portland Ave
Oklahoma City, OK 73120-5045
Phone (405) 936-1500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffdscott LLC CurrentSince Aug 11, 2024 Accepting new patients
Oklahoma City Anesthesia, LLC Anesthesiology CurrentSince Mar 1, 2002 Accepting new patients
Northwest Anesthesia PC Anesthesiology Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

11200 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 936-1000

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

3333 NW 63rd St
Ste 106
Oklahoma City, OK 73116

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

4317 W Memorial Rd
Oklahoma City, OK 73134
Phone (405) 755-6240

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1487614285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 NW 63RD ST STE 106",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163710",
            "telephone_number": "405-296-3270",
            "fax_number": "918-720-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205045",
            "telephone_number": "405-272-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "DANA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "17379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090470A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.