Active NPI
Sean D Boone, D.O.
- Family Medicine Physician
- Hugo, OK
National Provider Identifier
1629019237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3418
- Practice address
- 211 N 3Rd St
Hugo, OK 74743-3821 - Phone
- (580) 326-6111
- Fax
- (580) 326-0469
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3418 | OK | Primary |
Addresses
Primary practice location
211 N 3Rd St
Hugo, OK 74743-3821
Mailing address
211 N 3Rd St
Hugo, OK 74743-3821
Phone (580) 326-6111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100163220A | Medicaid | OK | |
| 100163220B | Medicaid | OK |
Other names 1
- Sean D Dawson
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090310000201 | OK | Practitioner - Family Practice | 2860558210 |
Receives reassigned benefits from 1 practitioner Practice locations: Hugo, OK |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
211 N 3Rd St
Hugo, OK 74743-3821
Phone (580) 326-6111
Hospital & facility affiliations
- Cypress Home Care
- Complete Hospice Care of Eastern Oklahoma
- Pushmataha Hospital
- Paris Regional Medical Center
- Elmbrook of Hugo
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3418 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmbrook of Hugo Operating Co., LLC | Past | Accepting new patients | |
| Family Medical Clinic | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- seanboone@fmedc.allscriptsdirect.net
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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Complete Hospice Care of Eastern Oklahoma | Hospice | Contracted Managing Employee | Mar 23, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Broken Bow, OK
- NPI 1881883148
Contracted Managing Employee
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- Hugo, OK
- NPI 1427770411
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Hugo, OK
- NPI 1336195312
-
- Community Based Hospice Care Agency
- Broken Bow, OK
- NPI 1881883148
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261353600000",
"number": "1629019237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 N 3RD ST",
"city": "HUGO",
"state": "OK",
"postal_code": "747433821",
"telephone_number": "580-326-6111",
"fax_number": "580-326-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 N 3RD ST",
"city": "HUGO",
"state": "OK",
"postal_code": "747433821",
"telephone_number": "580-326-6111",
"fax_number": "580-326-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONE",
"first_name": "SEAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2009-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "3418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100163220A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100163220B",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SEAN",
"last_name": "DAWSON",
"middle_name": "D",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hugo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.