NPIMap

Individual provider Active NPI

Michael Ryan Vaclaw, M.D.

  • Family Medicine Physician
  • Bartlesville, OK
National Provider Identifier
1942295308
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19519 Issued in OK
Practice address
510 SE Delaware Ave
Bartlesville, OK 74003-3635
Phone
(918) 331-2300
Fax
(918) 331-2399
NPI assigned
Sep 13, 2005
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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 19519 OK Primary

Addresses

Primary practice location

510 SE Delaware Ave
Bartlesville, OK 74003-3635

Mailing address

510 SE Delaware Ave
Bartlesville, OK 74003-3635
Phone (918) 331-2300

Other identifiers 2

IdentifierTypeStateIssuer
100230530AMedicaidOK
100255000AMedicaidOK

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
I20100713000640 OK Practitioner - Family Practice 7012952658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Associates PCGroup PAC ID 9335486174, 5 clinicians

Practice addresses (Care Compare)

510 SE Delaware Ave
Bartlesville, OK 74003-3635
Phone (918) 331-2330

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19519OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Phillips Memorial Medical Center, Inc. Past Accepting new patients
Bartlesville Care Center Inc. Past Accepting new patients
Heritage Villa Healthcare, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.vaclaw.1@21171.direct.athenahealth.com
  • Direct secure messaging: michael.vaclaw@direct.stjohnhealthsystem.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bartlesville Health & Rehabilitation CommunityBartlesville, OK, CCN 375110 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2004
May 1, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1942295308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SE DELAWARE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033635",
            "telephone_number": "918-331-2300",
            "fax_number": "918-331-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SE DELAWARE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033635",
            "telephone_number": "918-331-2300",
            "fax_number": "918-331-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACLAW",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "19519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230530A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100255000A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.