Individual provider Active NPI

Craige M Brestel, M.D.

  • Obstetrics & Gynecology Physician
  • Muskogee, OK
National Provider Identifier
1497762280
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
19912 Issued in OK
Practice address
3401 W Broadway St
Muskogee, OK 74401-2136
Phone
(918) 682-5477
Fax
(918) 687-5481
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 19912 OK Primary

Addresses

Primary practice location

3401 W Broadway St
Muskogee, OK 74401-2136

Mailing address

3401 W Broadway St
Muskogee, OK 74401-2136
Phone (918) 682-5477

Other identifiers 2

IdentifierTypeStateIssuer
100033120AMedicaidOK
100729650AMedicaidOK

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
I20110923000604 OK Practitioner - Obstetrics/Gynecology 1052332467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
JC Edwards School of Medicine, Marshall University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3401 W Broadway
Muskogee, OK 74401-2136
Phone (918) 687-5477

3401 W Broadway St
Muskogee, OK 74401-2136

3501 W Broadway
Muskogee, OK 74401-2136
Phone (918) 687-5477

Hospital & facility affiliations

  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19912OKMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Oklahoma, P.C. Obstetrics & Gynecology CurrentSince Sep 5, 2024 Accepting new patients
Craige M. Brestel, M.D. PLLC Obstetrics & Gynecology CurrentSince Jun 28, 2011 Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients

Locations

3502 W Broadway St
Muskogee, OK 74401
Phone (918) 682-2815

3401 W Broadway St
Muskogee, OK 74401
Phone (918) 687-5477

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Interoperability endpoints

  • Direct secure messaging: craige.brestel.1@14254.direct.athenahealth.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 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1497762280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012136",
            "telephone_number": "918-682-5477",
            "fax_number": "918-687-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012136",
            "telephone_number": "918-682-5477",
            "fax_number": "918-687-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESTEL",
        "first_name": "CRAIGE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "19912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033120A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100729650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.