Individual provider Active NPI

Paul S Erba, MD

  • Radiation Oncology Physician
  • Enid, OK
National Provider Identifier
1619050622
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
16411 Issued in OK
Practice address
600 S Monroe St
Enid, OK 73701-7211
Phone
(580) 233-3843
Fax
(580) 548-1484
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 16411 OK Primary

Addresses

Primary practice location

600 S Monroe St
Enid, OK 73701-7211

Mailing address

PO Box 5096
Enid, OK 73702-5096
Phone (580) 233-3843

Other identifiers 5

IdentifierTypeStateIssuer
731440959OtherOKTAX PAYER ID NUMBER
300006050OtherOKRAILROAD MC
A0001OtherOKTRICARE
100003480AMedicaidOK
788007OtherOKFIRST HEALTH

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
I20120717000605 OK Practitioner - Radiation Oncology 8921264011

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1619050622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737025096",
            "telephone_number": "580-233-3843",
            "fax_number": "580-548-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MONROE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017211",
            "telephone_number": "580-233-3843",
            "fax_number": "580-548-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERBA",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OK",
            "license": "16411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX PAYER ID NUMBER",
            "identifier": "731440959",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC",
            "identifier": "300006050",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A0001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003480A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "788007",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.