NPIMap

Individual provider Active NPI

Jason Michael Crouch, D.O.

  • Family Medicine Physician
  • Chandler, OK
National Provider Identifier
1497890115
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4290 Issued in OK
Practice address
806 Manvel Ave
Chandler, OK 74834-3858
Phone
(405) 258-9955
Fax
(405) 258-9930
NPI assigned
Feb 20, 2007
Last updated
Mar 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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 4290 OK Primary

Addresses

Primary practice location

806 Manvel Ave
Chandler, OK 74834-3858

Mailing address

806 Manvel Ave
Chandler, OK 74834-3858
Phone (405) 258-9955

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
I20070809000112 OK Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7517058241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crouch Family Medicine PCGroup PAC ID 2062503709, 2 clinicians

Practice addresses (Care Compare)

806 Manvel Ave
Chandler, OK 74834-3858
Phone (405) 258-9955

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions96
Removal of nail tissue1-10
Skin biopsy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4290OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crouch Family Medicine PC CurrentSince Jul 16, 2007 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

806 Manvel Ave
Chandler, OK 74834
Phone (405) 258-9955

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2867/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jason.crouch.1@2867.direct.athenahealth.com

Organizations & group practices 2

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 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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1497890115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 MANVEL AVE",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748343858",
            "telephone_number": "405-258-9955",
            "fax_number": "405-258-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 MANVEL AVE",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748343858",
            "telephone_number": "405-258-9955",
            "fax_number": "405-258-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, OK

Sources for this page

Verify at the official NPI Registry.