Individual provider Active NPI

Jarrod James Mueggenborg, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1629389432
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4935 Issued in OK
Practice address
4200 S Douglas Ave
Suite 306
Oklahoma City, OK 73109-3223
Phone
(405) 636-7195
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4935 OK Primary

Addresses

Primary practice location

4200 S Douglas Ave
Suite 306
Oklahoma City, OK 73109-3223

Mailing address

4200 S Douglas Ave
Suite 306
Oklahoma City, OK 73109-3223
Phone (405) 636-7195

Other identifiers 1

IdentifierTypeStateIssuer
200297210AMedicaidOK

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
I20110301000557 OK Practitioner - Emergency Medicine 3971784653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.69 of 100Reported as individual
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Oct 1, 2011 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Dec 16, 2012 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Apr 15, 2019 Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Integris Health Edmond, Inc Past Accepting new patients
Land Run Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

305 S 5th St
Enid, OK 73701
Phone (580) 233-6100

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

13500 S Tulsa Dr
Oklahoma City, OK 73170
Phone (405) 713-2696

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

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

Organizations & group practices 7

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1629389432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 S DOUGLAS AVE",
            "address_2": "SUITE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093223",
            "telephone_number": "405-636-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S DOUGLAS AVE",
            "address_2": "SUITE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093223",
            "telephone_number": "405-636-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUEGGENBORG",
        "first_name": "JARROD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200297210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.