NPIMap

Individual provider Active NPI

Stephen Trey Bastible, DO

  • Internal Medicine Physician
  • Sallisaw, OK
National Provider Identifier
1639745888
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7722 Issued in OK
Practice address
301 S J T Stites St
Sallisaw, OK 74955-9302
Phone
(918) 774-1400
NPI assigned
May 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7722 OK Primary

Addresses

Primary practice location

301 S J T Stites St
Sallisaw, OK 74955-9302

Mailing address

1400 E Downing St
Tahlequah, OK 74464-3324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725000507 TX Practitioner - Internal Medicine 1052857133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

301 S J T Stites St
Sallisaw, OK 74955-9302
Phone (918) 775-9150

Hospital & facility affiliations

  • Professional Home Health Home health agency, Sallisaw, OK, CCN 377588
  • Elara Caring Xviii Home health agency, Sallisaw, OK, CCN 377713
  • Cherokee Nation Home Health Services, Inc. Home health agency, Tahlequah, OK, CCN 377173
  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
  • Northeastern Health System Hospital, Tahlequah, OK, CCN 370089
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Sequoyah County-City of Sallisaw Hospital Authorit Hospital, Sallisaw, OK, CCN 370112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7722OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jul 14, 2024 Accepting new patients
Cherokee Nation CurrentSince Jul 14, 2024 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 4

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1639745888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S J T STITES ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749559302",
            "telephone_number": "918-774-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIBLE",
        "first_name": "STEPHEN",
        "middle_name": "TREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-28",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "7722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

Verify at the official NPI Registry.