Individual provider Active NPI

Gregory Don Balcerak, DO

  • Internal Medicine Physician
  • Stillwater, OK
National Provider Identifier
1538839154
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8596 Issued in OK
Practice address
1815 W 6TH Ave
Stillwater, OK 74074-4202
Phone
(405) 743-7300
NPI assigned
Sep 15, 2021
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8596 OK Primary

Addresses

Primary practice location

1815 W 6TH Ave
Stillwater, OK 74074-4202

Mailing address

501 Copperfield Dr
Edmond, OK 73003-6177

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
I20230802001622 OK Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850752189

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

501 Copperfield Dr
Edmond, OK 73003-6177

PO Box
Kansas City, MO 64180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8596OKMDDentist

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1538839154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 COPPERFIELD DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730036177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744202",
            "telephone_number": "405-743-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCERAK",
        "first_name": "GREGORY",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "8596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.