Matthew T Draelos MD PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

15748 Issued in OK

Legal business name

MATTHEW T DRAELOS MD PC

Practice address

200 N Bryant Ave
Suite 100
Edmond, OK 73034-6273

Phone

(405) 330-2362

Fax

(405) 330-2363

NPI assigned

Feb 25, 2008

Last updated

Oct 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Theodore Draelos, MDNPI 1437221694

Title

Owner/Operator

Phone

(405) 330-2362

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Theodore Draelos, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Edmond, OK
  • NPI 1437221694
  Medicare reassignment NPD Authorized official
• Dao The Anh Goodnight, APRN, CNP, FNP-C

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1184234148
  Medicare reassignment
• Miranda High

  • Family Nurse Practitioner
  • Tuttle, OK
  • NPI 1215529078
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1821267717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BRYANT AVE",
            "address_2": "SUITE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346273",
            "telephone_number": "405-330-2362",
            "fax_number": "405-330-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BRYANT AVE",
            "address_2": "SUITE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346273",
            "telephone_number": "405-330-2362",
            "fax_number": "405-330-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW T DRAELOS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "DRAELOS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "405-330-2362",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "15748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TPAN",
            "identifier": "OKB5063",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basil Mathews, MD
• Daniel Mathews
• Alexis Paris Mathis
• Carol Mathison, L.P.C.
• Mark Jeffrey Mathison
• Katelyn Elizabeth Matthews, PT, DPT
• Ladaysha Matthews
• London Matthews
• Mattison Pathology LLP
• Mattison Pathology, L.L.P.

• Endocrinology, Diabetes & Metabolism Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Endocrinology, Diabetes & Metabolism Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.