Robert Niebergall, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13607 Issued in OK

Practice address

800 W Boise Cir Ste 160
Broken Arrow, OK 74012-4932

Phone

(918) 994-9160

Fax

(918) 403-6306

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment NPD
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment NPD
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD
• South Tulsa Medical Group LLC

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1518998483
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1912975012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W BOISE CIR STE 160",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124932",
            "telephone_number": "918-994-9160",
            "fax_number": "918-403-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W BOISE CIR STE 160",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124932",
            "telephone_number": "918-994-9160",
            "fax_number": "918-403-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBERGALL",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "13607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "800522535",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100014070A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xuan T Nguyen, REGISTERED DIETITIAN
• Yenny Nguyen
• Samantha Anne Nibbelink
• Whitney Nicholas, MS CCC-SLP
• Bonnie Nicholls, LCSW
• Krista Nissen
• Emmalee Nitti, MS, CCC-SLP
• Njoy Tulsa LLC
• Bethany Leigh Noble
• Sarah Catherine Noble, APRN, CNM

• Internal Medicine Physician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.