Semira Charboneau, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4038 Issued in OK

Practice address

905 Colony Dr
Ada, OK 74820-2329

Phone

(580) 436-5111

NPI assigned

Jul 12, 2005

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Internal Medicine

Education

Oklahoma State University College of Osteopathic Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Oklahoma Family Medical Center IncGroup PAC ID 9931189685, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health of Central Oklahoma Home health agency, Norman, OK, CCN 377196
• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
• Norman Regional Hospital, Norman, OK, CCN 370008
• Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: semira.charboneau@cof.eclinicaldirectplus.com

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.

• Central Oklahoma Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Konawa, OK
  • NPI 1831291293
  Medicare reassignment Care Compare group NPD
• Central Oklahoma Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ada, OK
  • NPI 1770399008
  NPD
• General Medical Consultants, Inc

  • Internal Medicine Physician
  • New Albany, OH
  • NPI 1285774281
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Healthcare Innovations-Travertine Health Services, LLC

  dba Enhabit Home Health of Central Oklahoma

  • Home Health Agency
  • Norman, OK
  • NPI 1689654949
  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  dba Mercy Hospital Ada

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation
• Mercy Hospital Ardmore, Inc.

  • General Acute Care Hospital
  • Ardmore, OK
  • NPI 1386741635
  Care Compare affiliation
• Norman Regional Hospital Authority

  dba Norman Regional

  • General Acute Care Hospital
  • Norman, OK
  • NPI 1700882578
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1619975745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 COLONY DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202329",
            "telephone_number": "580-436-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Konawa",
            "state": "OK",
            "postal_code": "748491415",
            "country_code": "US",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARBONEAU",
        "first_name": "SEMIRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "4038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011300A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILDROAD MEDICARE",
            "identifier": "P00035275",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Oklahoma Family Medical Center, Inc.
• Sherri R Chandler, MS
• Toni Chappell, B.A.
• Dan Charboneau, PHYSICAL THERAPIST
• Roger John Charboneau, D.O.
• Charles R Vest M.D.
• Scott Charlton, PHARM. D.
• Cameron Chavez, LMSW
• Larry Oliver Chesser, MSW
• Keith Forrest Chew, L.P.C.

• Internal Medicine Physician in Ada, OK
• Providers in Ada, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.

Verify at the official NPI Registry.