DEACON VICE (D.O.) – Emergency Medicine Physician, NPI 1073934352
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
747 EMERGENCY MEDICINE in OK
Provider Addresses for DEACON VICE (D.O.)
4200 S. DOUGLAS
SUITE 306
OKLAHOMA CIRY, OK 73109
Phone:
Type: Mailing
900 17th St
Woodward, OK 738012448
Phone: (580) 256-5511
Type: Location
5501 N Portland Ave
Oklahoma City, OK 731122074
Phone: (405) 604-6000
Type: Location
3300 NW Expwy
Oklahoma City, OK 731124418
Phone: (405) 949-3011
Type: Location
1201 Health Center Pkwy
Yukon, OK 730996381
Phone: (405) 717-6800
Type: Location
4401 S Western Ave
Oklahoma City, OK 731093413
Phone: (405) 636-7709
Type: Location
1323 W 6th Ave
Stillwater, OK 740744306
Phone: (405) 742-5454
Type: Location
4801 Integris Pkwy
Edmond, OK 730348864
Phone: (405) 713-4565
Type: Location
4200 S DOUGLAS AVE
SUITE 306
OKLAHOMA CITY, OK 731093223
Phone: (405) 636-7709
Type: Location
307 S EVERGREEN AVE
WOODBURY, NJ 080962739
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141121000573 | I | Emergency Medicine | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 380 | 335 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 370 | 324 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 181 | 170 | $0 |
| 99282 | Emergency department visit with straightforward medical decision making | 81 | 78 | $0 |
| 99291 | Critical care, first 30-74 minutes | 50 | 49 | $0 |
Insurance plans in this area (ZIP 73109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Family Practice | OK | |
| Emergency Medicine | OK | |
| - | OK | |
| Family Practice | OK | |
| General Surgery | TX | |
| Family Practice, Emergency Medicine | OK | |
| Pain Management | OK | |
| Nurse Practitioner | OK | |
| Internal Medicine | OK |
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