NPIMap

Individual provider Active NPI

Breece Michael Eberley, M.D.

  • Internal Medicine Physician
  • Owasso, OK
National Provider Identifier
1689626376
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21230 Issued in OK
Practice address
10502 N 110TH East Ave
Owasso, OK 74055-6655
Phone
(918) 376-8190
Fax
(918) 376-8479
NPI assigned
May 17, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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 21230 OK Primary

Addresses

Primary practice location

10502 N 110TH East Ave
Owasso, OK 74055-6655

Mailing address

603 North Progress Ave
Siloam Springs, AR 72761-4353
Phone (479) 215-3050

Other identifiers 1

IdentifierTypeStateIssuer
100259460AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040420000424 OK Practitioner - Internal Medicine 6608861497 Reassigns benefits to 3 organizations
I20150227000466 AR Practitioner - Internal Medicine 6608861497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Hospital Medicine Physicians Group, LLCGroup PAC ID 7214327832, 132 clinicians

Practice addresses (Care Compare)

10502 N 110TH E Ave
Bailey Medical Center
Owasso, OK 74055-6655
Phone (918) 579-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21230OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
HCC Duncan Inc CurrentSince Apr 19, 2009 Accepting new patients
Siloam Springs Clinic Company LLC Internal Medicine CurrentSince Jan 17, 2015 Accepting new patients
Tulsa Hospital Medicine Physicians Group, LLC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Hospital Care Consultants Region II Inc Internal Medicine CurrentSince Nov 8, 2014 Accepting new patients
Midwest Hospital Medicine Associates PC Past Accepting new patients
Bailey Medical Center, LLC Past Accepting new patients
Britton Vision Associates Inc Past Accepting new patients
Atoka County Healthcare Authority Past Accepting new patients
Watonga Hospital Trust Authority Past Accepting new patients
Watonga Hospital Trust Authority Past Accepting new patients
Claremore Internal Medicine, LLC Internal Medicine Past Accepting new patients
Ahs Southcrest Hospital, LLC Past Accepting new patients
Ahs Pryor Hospital, LLC Past Accepting new patients
Hospital Care Consultants of Sallisaw Past Accepting new patients
Radiation Oncology Services Inc Past Accepting new patients
Claremore Physicians LLC Past Accepting new patients

Locations

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556

1407 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-8458

1801 W 3rd St
Elk City, OK 73644
Phone 40584358551407

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

Interoperability endpoints

  • Direct secure messaging: beberley112688@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/BMC/api/FHIR/R4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Meyer C and Ida Miller HospiceTulsa, OK, CCN 371634 Hospice Contracted Managing Employee (5%) Jan 2, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1689626376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 NORTH PROGRESS AVE",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614353",
            "telephone_number": "479-215-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 N 110TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556655",
            "telephone_number": "918-376-8190",
            "fax_number": "918-376-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLEY",
        "first_name": "BREECE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "21230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259460A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.