Individual provider Active NPI

Derek M Matheson, DO

  • Internal Medicine Physician
  • Owasso, OK
National Provider Identifier
1780765719
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4359 Issued in OK
Practice address
11402 N 135TH East Ave
Owasso, OK 74055-5701
Phone
(918) 331-1089
Fax
(918) 331-1823
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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 4359 OK Primary

Addresses

Primary practice location

11402 N 135TH East Ave
Owasso, OK 74055-5701

Mailing address

11402 N 135TH East Ave
Owasso, OK 74055-5701
Phone (918) 212-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110128001014 OK Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Neurology 2668651118 Reassigns benefits to 4 organizations
I20220221001457 TX Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Neurology 2668651118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Neurology
Education
Oklahoma State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

11402 N 135TH E Ave
Owasso, OK 74055-5701
Phone (918) 212-7373

19600 E Ross St
CN Outpatient Health Center
Tahlequah, OK 74464-0545
Phone (918) 458-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4359OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 1, 2011 Accepting new patients
Cherokee Nation CurrentSince Feb 14, 2022 Accepting new patients
Omni Medical Group Inc Internal Medicine CurrentSince Oct 15, 2012 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 1, 2022 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 1, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 1, 2022 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Ahs Oklahoma Physician Group LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Cherokee Nation CurrentSince Feb 14, 2022 Accepting new patients
Creek Nation Hospital & Clinics Internal Medicine Current Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

226 SE Debell Ave
Bldg A
Bartlesville, OK 74006
Phone (918) 333-7200

3500 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-1555

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 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

11402 N 135th East Ave
Owasso, OK 74055
Phone (918) 212-7373

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

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

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

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Dept 1038
Tulsa, OK 74182

Dept 1206
Tulsa, OK 74182

Dept 2269
Tulsa, OK 74182

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

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

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

Interoperability endpoints

  • Direct secure messaging: derek.matheson@direct.stjohnhealthsystem.com
  • Direct secure messaging: dmatheson561196@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: dmatheson20473@muscogeecreeknation.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1780765719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11402 N 135TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555701",
            "telephone_number": "918-212-7373",
            "fax_number": "918-550-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11402 N 135TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555701",
            "telephone_number": "918-331-1089",
            "fax_number": "918-331-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "DEREK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.