Active NPI
Walter Mark Boomer, MD
- Pulmonary Disease Physician
- Oklahoma City, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 17300
- Practice address
- 13313 N Meridian Ave Ste D
Oklahoma City, OK 73120-8316 - Phone
- (405) 755-4290
- Fax
- (405) 755-7773
- NPI assigned
- Jul 12, 2006
- Last updated
- Jan 14, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 17300 | OK | Primary |
Addresses
Primary practice location
13313 N Meridian Ave Ste D
Oklahoma City, OK 73120-8316
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100090560A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- University of Oklahoma College of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333
1313 E 20TH St
Okmulgee Indian Health Center
Okmulgee, OK 74447-6303
Phone (918) 591-5700
4318 W Okmulgee St
Muskogee, OK 74401-4648
Phone (918) 683-1831
5200 E I 240 Service Rd
Suite 330
Oklahoma City, OK 73135-2607
Phone (405) 755-4290
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Mercy Clinic Oklahoma Communities | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Saint Francis Hospital, Inc. | Past | Accepting new patients |
Locations
13313 N Meridian Ave
Ste D
Oklahoma City, OK 73120
Phone (405) 529-5759
4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455
5200 E I 240 Service Rd
Ste 330
Oklahoma City, OK 73135
Phone (405) 416-9703
1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641
1401 Morris Dr
Ste 204
Okmulgee, OK 74447
900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448
1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310
10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760
Dept 1038
Tulsa, OK 74182
Dept 1467
Tulsa, OK 74182
Interoperability endpoints
- wboomer17932@muscogeecreeknation.direct-ci.com
- wboomer60874@direct.saintfrancis.com
Organizations & group practices 6
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.
-
dba Creek Nation Community Hospital
- Family Medicine Physician
- Okemah, OK
- NPI 1467053173
TX
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1386874550
-
- General Practice Physician
- Tulsa, OK
- NPI 1174582282
-
dba Creek Nation Health System
- Clinic/Center
- Muskogee, OK
- NPI 1366593923
-
dba Muscogee Healing and Recovery Center
- Clinic/Center
- Muskogee, OK
- NPI 1922873611
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1144228487
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1184721722
-
dba Saint Francis Hospital Muskogee
- General Acute Care Hospital
- Muskogee, OK
- NPI 1386188837
-
dba Saint Francis Hospital South
- General Acute Care Hospital
- Tulsa, OK
- NPI 1376561944
-
- Rehabilitation Hospital Unit
- Tulsa, OK
- NPI 1003039488
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1144228487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768348800000",
"number": "1578598074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776084",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776084",
"telephone_number": "314-364-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13313 N MERIDIAN AVE STE D",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731208316",
"telephone_number": "405-755-4290",
"fax_number": "405-755-7773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOMER",
"first_name": "WALTER",
"middle_name": "MARK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2026-01-14",
"certification_date": "2026-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OK",
"license": "17300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100090560A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.