Individual provider Active NPI

Sudhir R Daftary, MD

  • Anesthesiology Physician
  • Muskogee, OK
National Provider Identifier
1609978097
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23519 Issued in OK
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 684-2557
Fax
(405) 948-6507
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23519 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

PO Box 1664
Muskogee, OK 74402-1664
Phone (405) 947-8585

Other identifiers 1

IdentifierTypeStateIssuer
P00201962OtherOKMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Surgical Care LP Past Accepting new patients
Providence Physician Group Inc Anesthesiology Past Accepting new patients
Jer Medical Associates Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609978097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1664",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744021664",
            "telephone_number": "405-947-8585",
            "fax_number": "405-948-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-684-2557",
            "fax_number": "405-948-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFTARY",
        "first_name": "SUDHIR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "23519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00201962",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.