NPIMap

Individual provider Active NPI

Jacob Archer, M.D.

  • Neurological Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1609257914
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
38587 Issued in OK
Practice address
14101 Parkway Commons Dr
Oklahoma City, OK 73134-6012
Phone
(405) 749-2700
NPI assigned
Jun 11, 2015
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11018403A IN
Neurological Surgery Physician 207T00000X 38587 OK Primary

Addresses

Primary practice location

14101 Parkway Commons Dr
Oklahoma City, OK 73134-6012

Mailing address

355 W 16TH St Ste 5100
Indianapolis, IN 46202-2274
Phone (317) 396-1300

Other practice location 1

355 W 16th St Ste 5100
Indianapolis, IN 46202-2274
Phone (317) 396-1300

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
I20220715000975 OK Practitioner - Neurosurgery 0345530366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Oklahoma College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuroscience Specialists PCGroup PAC ID 3375456718, 17 clinicians

Practice addresses (Care Compare)

14100 Pkwy Commons Dr
Suite 100
Oklahoma City, OK 73134-6036
Phone (405) 748-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.89 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.31

Merit-based Incentive Payment System (MIPS)

Final score
70.05 of 100Reported as group
Quality
52.07
Promoting interoperability
100
Improvement activities
40
Cost
48.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion697
Laminectomy or laminotomy (partial removal of spine bones)135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38587OKMDNeurological Surgery Physician
11018403AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Spine Hospital LLC CurrentSince Jul 1, 2022 Accepting new patients
Neuroscience Specialists PC Neurological Surgery CurrentSince Jan 1, 2025 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Major Hospital Past Accepting new patients
Summit Medical Center Past Accepting new patients
Oklahoma Spine Hospital LLC Past Accepting new patients

Locations

2781 Washington Dr
#101
Norman, OK 73069
Phone (405) 749-2765

14100 Parkway Commons Dr
Oklahoma City, OK 73134
Phone (405) 270-0500

14100 Parkway Commons Dr
Ste 100
Oklahoma City, OK 73134
Phone (405) 242-4720

14101 Parkway Commons Dr
Oklahoma City, OK 73134
Phone (405) 749-2700

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/okspine-12f0832f
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oklahoma Spine Hospital, L.L.C.Oklahoma City, OK, CCN 370206 Hospital 5% Or Greater Indirect Ownership Interest (2.55%) Dec 31, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1609257914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST STE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022274",
            "telephone_number": "317-396-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 PARKWAY COMMONS DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346012",
            "telephone_number": "405-749-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 W 16th St Ste 5100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022274",
            "country_code": "US",
            "telephone_number": "317-396-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018403A",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "38587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.