Individual provider Active NPI

Mark Matthew Mims, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1679991475
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
35702 Issued in OK
Practice address
825 NE 10TH St Ste 4C
Oklahoma City, OK 73104-5417
Phone
(405) 271-1368
NPI assigned
Mar 31, 2014
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 35702 OK Primary

Addresses

Primary practice location

825 NE 10TH St Ste 4C
Oklahoma City, OK 73104-5417

Mailing address

800 Stanton L Young Blvd # 1400
Oklahoma City, OK 73104-5018
Phone (210) 241-6275

Other practice location 1

101 Manning Dr # 7070
Chapel Hill, NC 27514
Phone (919) 843-7091

Other practice location 2

203 Lothrop St
Suite 500
Pittsburgh, PA 15213-2548
Phone (210) 241-6275

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
I20200812003655 OK Practitioner - Otolaryngology 4183953995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

711 Stanton L Young Blvd
Oklahoma City, OK 73104-5023
Phone (405) 271-4700

800 NE 10TH St
Ouhp Stephenson Cancer Center
Oklahoma City, OK 73104-5418
Phone (405) 271-1112

825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 1, 2020 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 1, 2020 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

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

825 NE 10th St
Ste 4C
Oklahoma City, OK 73104
Phone (405) 271-1368

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

Interoperability endpoints

  • Direct secure messaging: mmims22293@ouhealth.direct-ci.net

Organizations & group practices 5

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1679991475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STANTON L YOUNG BLVD # 1400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045018",
            "telephone_number": "210-241-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 10TH ST STE 4C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045417",
            "telephone_number": "405-271-1368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr # 7070",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "27514",
            "country_code": "US",
            "telephone_number": "919-843-7091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "203 Lothrop St",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132548",
            "country_code": "US",
            "telephone_number": "210-241-6275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMS",
        "first_name": "MARK",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OK",
            "license": "35702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.