NPIMap

Individual provider Active NPI

Myrto Eliades, M.D

  • Endocrinology, Diabetes & Metabolism Physician
  • Oklahoma City, OK
National Provider Identifier
1487965976
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
34650 Issued in OK
Practice address
5401 N Portland Ave Ste 410
Oklahoma City, OK 73112-2131
Phone
(405) 945-4700
Fax
(405) 945-4270
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25 MA09890400 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 34650 OK Primary

Addresses

Primary practice location

5401 N Portland Ave Ste 410
Oklahoma City, OK 73112-2131

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (405) 945-4700

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
I20191014002245 OK Practitioner - Endocrinology 2062642440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3433 NW 56TH St
710 Integris Endo North
Oklahoma City, OK 73112-4430
Phone (405) 945-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25 MA09890400NJMDEndocrinology, Diabetes & Metabolism Physician
34650OKMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Endocrinology, Diabetes & Metabolism CurrentSince Oct 15, 2019 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5401 N Portland Ave
Ste 410
Oklahoma City, OK 73112
Phone (405) 604-4202

3433 NW 56th St
Ste 710
Oklahoma City, OK 73112
Phone (405) 945-4345

3366 NW Expressway St
Ste 200
Oklahoma City, OK 73112
Phone (405) 713-9930

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Interoperability endpoints

  • Direct secure messaging: meliades190132@direct.integrisok.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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1487965976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-945-4700",
            "fax_number": "405-945-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE STE 410",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122131",
            "telephone_number": "405-945-4700",
            "fax_number": "405-945-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIADES",
        "first_name": "MYRTO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25 MA09890400",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "34650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.