Individual provider Active NPI

Edith J Lubin, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1780607952
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29534 Issued in OK
Practice address
100 NE 5TH St
Oklahoma City, OK 73104-2228
Phone
(888) 803-3070
Fax
(888) 803-3331
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 29534 OK Primary

Addresses

Primary practice location

100 NE 5TH St
Oklahoma City, OK 73104-2228

Mailing address

100 NE 5TH St
Oklahoma City, OK 73104-2228
Phone (888) 803-3370

Other identifiers 1

IdentifierTypeStateIssuer
200445240AMedicaidOK

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
I20131226001551 OK Practitioner - Family Practice 8820154206 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29534OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Health Clinic, PLLC Family Medicine CurrentSince Aug 25, 2024 Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc. CurrentSince Apr 19, 2022 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc Current Accepting new patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Apr 19, 2022 Accepting new patients
Archwell Health Professional Services of Oklahoma, LLC CurrentSince Oct 22, 2024 Accepting new patients

Locations

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

3138 S Garnett Rd
Tulsa, OK 74146
Phone (918) 203-7005

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1780607952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE 5TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731042228",
            "telephone_number": "888-803-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE 5TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731042228",
            "telephone_number": "888-803-3070",
            "fax_number": "888-803-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBIN",
        "first_name": "EDITH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "29534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200445240A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.