NPIMap

Individual provider Active NPI

Derek Means

  • Family Medicine Physician
  • Owasso, OK
National Provider Identifier
1740771013
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37987 Issued in OK
Practice address
12455 E 100TH St N Ste 350
Owasso, OK 74055-4675
Phone
(918) 274-5510
Fax
(918) 403-6312
NPI assigned
May 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37987 OK Primary

Addresses

Primary practice location

12455 E 100TH St N Ste 350
Owasso, OK 74055-4675

Mailing address

12455 E 100TH St N Ste 350
Owasso, OK 74055-4675
Phone (918) 274-5510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 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
I20191023000530 AR Practitioner - Family PracticePractitioner - Emergency Medicine 5294082467 Reassigns benefits to 3 organizations
I20210825002957 OK Practitioner - Family Practice 5294082467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2967

Hospital & facility affiliations

  • Enhabit Home Health of Northeast Oklahoma Home health agency, Broken Arrow, OK, CCN 377572
  • Vitalcaring Group Home health agency, Tulsa, OK, CCN 377787
  • Complete Home Health of Western Oklahoma Home health agency, Enid, OK, CCN 377167
  • Ascension at Home - Tulsa Home health agency, Tulsa, OK, CCN 377073
  • Truheart Home Health Home health agency, Tulsa, OK, CCN 377615
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St John Urgent Care Clinics Inc CurrentSince Aug 30, 2021 Accepting new patients
Emergency Staffing Solutions Region III CurrentSince Jul 1, 2020 Accepting new patients
Ess of Fordyce LLC CurrentSince Nov 15, 2019 Accepting new patients
Omni Medical Group Inc Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Nov 15, 2019 Accepting new patients
Summit Medical Center Past Accepting new patients
St John Medical Center Inc Past Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients

Locations

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

101 Hospital Dr
Magnolia, AR 71753
Phone (870) 235-3000

12455 E 100th St N
Ste 220
Owasso, OK 74055
Phone (918) 274-5555

12455 E 100th St N
Ste 350
Owasso, OK 74055
Phone (918) 274-5510

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 8

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 11

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": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1740771013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 350",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-274-5510",
            "fax_number": "918-403-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 350",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-274-5510",
            "fax_number": "918-403-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEANS",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "37987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.