NPIMap

Individual provider Active NPI

Verapan Vongthavaravat, M.D.

  • Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1528199866
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
21093 Issued in OK
Practice address
4811 Gaillardia Pkwy Ste 200
Oklahoma City, OK 73142-1874
Phone
(405) 751-4199
Fax
(405) 607-1848
NPI assigned
Mar 8, 2007
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 21093 OK Primary

Addresses

Primary practice location

4811 Gaillardia Pkwy Ste 200
Oklahoma City, OK 73142-1874

Mailing address

4811 Gaillardia Pkwy Ste 200
Oklahoma City, OK 73142-1874
Phone (405) 751-4199

Other identifiers 8

IdentifierTypeStateIssuer
7605381OtherWAAETNA
8428732MedicaidWA
1017VAOtherWAREGENCE BLUE SHIELD
1017VAOtherWAASURIS NW
213563MedicaidOR
5166925OtherWAPPNI
5741926OtherWAFIRST HEALTH CCN COVENTRY
9395857OtherWAPCHS MULTIPLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060116000141 OK Practitioner - Gastroenterology 0345273553 Reassigns benefits to 3 organizations
I20251215000510 TX Practitioner - Gastroenterology 0345273553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease Specialists IncGroup PAC ID 7315939279, 18 clinicians

Practice addresses (Care Compare)

10029 N Oklahoma Ave
Suite 200
Oklahoma City, OK 73114-7454
Phone (405) 702-1300

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.66 of 100Reported as individual
Quality
76.73
Improvement activities
0
Cost
71.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy131
Upper gastrointestinal (GI) endoscopy for acid reflux268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health CurrentSince Dec 2, 2025 Accepting new patients
Integris Ddsi Endoscopy Centers LLC CurrentSince Feb 1, 2021 Accepting new patients
Integris Ddsi Endoscopy Centers LLC CurrentSince Feb 1, 2021 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Dec 2, 2025 Accepting new patients
Sittilerk Trikalsaransukh PastSince Feb 1, 2006 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center Past Accepting new patients
Digestive Disease Pathology LLC Past Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

10029 N Oklahoma Ave
Ste 200
Oklahoma City, OK 73114
Phone (405) 702-1300

3366 NW Expressway St
Ste 400
Oklahoma City, OK 73112
Phone (405) 702-1300

4201 S Western Ave
Oklahoma City, OK 73109
Phone (405) 632-4000

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Interoperability endpoints

  • Direct secure messaging: vvongthavaravat23278@direct.integrisok.com

Organizations & group practices 9

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1528199866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 GAILLARDIA PKWY STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731421874",
            "telephone_number": "405-751-4199",
            "fax_number": "405-607-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 GAILLARDIA PKWY STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731421874",
            "telephone_number": "405-751-4199",
            "fax_number": "405-607-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGTHAVARAVAT",
        "first_name": "VERAPAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "21093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7605381",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8428732",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "1017VA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW",
            "identifier": "1017VA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213563",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPNI",
            "identifier": "5166925",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CCN COVENTRY",
            "identifier": "5741926",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCHS MULTIPLAN",
            "identifier": "9395857",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.