NPIMap

Individual provider Active NPI

Landon Riesenberg, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1588286546
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7313 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 830-7582
NPI assigned
May 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 7313 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

9601 Forest Glade Dr
Oklahoma City, OK 73151-9160
Phone (405) 830-7582

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
I20210920002252 OK Practitioner - Emergency Medicine 6103223003 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services of Oklahoma PCGroup PAC ID 8123209012, 63 clinicians

Practice addresses (Care Compare)

3300 NW Expwy
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7313OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County Inc Current Accepting new patients
Grady Memorial Hospital CurrentSince Jun 1, 2022 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Mar 11, 2022 Accepting new patients
Farmers Union Hospital Association CurrentSince Sep 15, 2021 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
Farmers Union Hospital Association Current Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Mercy Hospital Kingfisher, Inc CurrentSince Mar 11, 2022 Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

1800 W 1st St
Ste 3
Elk City, OK 73644
Phone (580) 225-4699

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1500 N Green Ave
Purcell, OK 73080
Phone (405) 527-2250

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Interoperability endpoints

  • Direct secure messaging: lriesenberg425133@direct-ehr-ssmhc.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1588286546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 FOREST GLADE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731519160",
            "telephone_number": "405-830-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-830-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESENBERG",
        "first_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.