Individual provider Active NPI

Daniel Scott Matlock, CRNA

  • Certified Registered Nurse Anesthetist
  • Norman, OK
National Provider Identifier
1992765838
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R0064933 Issued in OK
Practice address
3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202
Phone
(405) 701-3418
Fax
(405) 701-3451
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R0064933 OK Primary

Addresses

Primary practice location

3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202

Mailing address

3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202
Phone (405) 701-3418

Other identifiers 1

IdentifierTypeStateIssuer
200077660AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060523000100 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496766834 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anthony Shawnee Hospital IncGroup PAC ID 1052567328, 15 clinicians

Practice addresses (Care Compare)

1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 878-8110

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149

Merit-based Incentive Payment System (MIPS)

Final score
99.2 of 100Reported as group
Quality
93.03
Promoting interoperability
100
Improvement activities
40
Cost
93.93

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0064933OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Shawnee Hospital Inc CurrentSince Jan 15, 2018 Accepting new patients
St. Anthony Shawnee Hospital, Inc. CurrentSince Jan 15, 2018 Accepting new patients
Nga Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2017 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

1515 N Porter Ave
Norman, OK 73071
Phone (405) 366-8619

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1992765838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 W ROCK CREEK RD",
            "address_2": "SUITE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722202",
            "telephone_number": "405-701-3418",
            "fax_number": "405-701-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 W ROCK CREEK RD",
            "address_2": "SUITE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722202",
            "telephone_number": "405-701-3418",
            "fax_number": "405-701-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R0064933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200077660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.