NPIMap

Individual provider Active NPI

Alex Norman Detwiler, D.O.

  • Orthopaedic Surgery of the Spine Physician
  • Stillwater, OK
National Provider Identifier
1831519107
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
5730 Issued in OK
Practice address
1301 W 6TH Ave Ste 207
Stillwater, OK 74074-4381
Phone
(405) 707-0900
Fax
(405) 707-3363
NPI assigned
Apr 24, 2014
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 5730 OK Primary

Addresses

Primary practice location

1301 W 6TH Ave Ste 207
Stillwater, OK 74074-4381

Mailing address

1301 W 6TH Ave Ste 207
Stillwater, OK 74074-4381
Phone (405) 707-0900

Other identifiers 1

IdentifierTypeStateIssuer
5730OtherOKORTHOPEDIC SURGERY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200909003265 OK Practitioner - Orthopedic Surgery 2961820816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 W 6TH Ave
Suite 207
Stillwater, OK 74074-4381
Phone (405) 533-6990

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion133
Laminectomy or laminotomy (partial removal of spine bones)21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5730OKMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2020 Accepting new patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2020 Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1301 W 6th Ave
Ste 207
Stillwater, OK 74074
Phone (405) 533-3010

Interoperability endpoints

  • Direct secure messaging: alex.detwiler.p1@direct.smc.nextgenshare.com

Organizations & group practices 3

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.

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1831519107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W 6TH AVE STE 207",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744381",
            "telephone_number": "405-707-0900",
            "fax_number": "405-707-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W 6TH AVE STE 207",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744381",
            "telephone_number": "405-707-0900",
            "fax_number": "405-707-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "ALEX",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OK",
            "license": "5730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHOPEDIC SURGERY",
            "identifier": "5730",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.