Individual provider Active NPI

Cameron Tate Aviles, NP

  • Acute Care Nurse Practitioner
  • McAlester, OK
National Provider Identifier
1629958483
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
210403 Issued in OK
Practice address
1805 Mockingbird LN
McAlester, OK 74501-7312
Phone
(501) 920-2630
NPI assigned
Sep 3, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 210403 OK Primary

Addresses

Primary practice location

1805 Mockingbird LN
McAlester, OK 74501-7312

Mailing address

1805 Mockingbird LN
McAlester, OK 74501-7312
Phone (501) 920-2630

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251203002702 OK Practitioner - Nurse Practitioner 3779076203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 E Clark Bass Blvd
McAlester, OK 74501-4209

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
210403OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McAlester Regional Health Center Authority CurrentSince Oct 30, 2025 Accepting new patients
McAlester Regional Health Center Authority Past Accepting new patients

Locations

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1629958483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 MOCKINGBIRD LN",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745017312",
            "telephone_number": "501-920-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MOCKINGBIRD LN",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745017312",
            "telephone_number": "501-920-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "CAMERON",
        "middle_name": "TATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "210403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.