Individual provider Active NPI

Michael Alpheus Tribbey, MD

  • Neurology Physician
  • Oklahoma City, OK
National Provider Identifier
1629040506
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
11840 Issued in OK
Practice address
4120 W Memorial Rd
Suite 218
Oklahoma City, OK 73120-9322
Phone
(405) 302-2661
Fax
(405) 302-2670
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 11840 OK Primary

Addresses

Primary practice location

4120 W Memorial Rd
Suite 218
Oklahoma City, OK 73120-9322

Mailing address

4401 W Memorial Rd
Suite 140
Oklahoma City, OK 73134-1785
Phone (405) 752-3162

Other identifiers 1

IdentifierTypeStateIssuer
100117490AMedicaidOK

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
I20090303000331 OK Practitioner - Neurology 6800879719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Oklahoma College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 NE 13TH St
Ori274J
Oklahoma City, OK 73117-1039

4120 W Memorial Rd
Suite 218
Oklahoma City, OK 73120-9322

4401 W Memorial Rd
Oklahoma City, OK 73134-1787

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11840OKMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Jul 13, 2011 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 1, 2011 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 6, 2018 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 6, 2018 Accepting new patients
Stillwater Medical Center Authority CurrentSince Jul 13, 2011 Accepting new patients
Stillwater Medical Center Authority Neurology Current Accepting new patients
Medical Neurologists Inc Neurology PastSince Jun 11, 2004 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

825 NE 10th St
#5B
Oklahoma City, OK 73104
Phone (405) 271-3635

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

4120 W Memorial Rd
Ste 218
Oklahoma City, OK 73120
Phone (405) 302-2661

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 8

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1629040506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-752-3162",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD",
            "address_2": "SUITE 218",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209322",
            "telephone_number": "405-302-2661",
            "fax_number": "405-302-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBBEY",
        "first_name": "MICHAEL",
        "middle_name": "ALPHEUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "11840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100117490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.