DR. EBENEZER SAMPONG (DO) – Emergency Medicine Physician, NPI 1093246613

DR. EBENEZER SAMPONG (DO) is a healthcare provider. based in Tulsa, Oklahoma. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 28989 (MS). The NPI Number for DR. EBENEZER SAMPONG (DO) is 1093246613

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. EBENEZER SAMPONG (DO)
NPI
1093246613
Phone
(918) 671-2813
Address
9012 S. College Ave.
Enumeration Date
24 March 2017
Last Update Date
29 July 2024

Doctor Profile

Medical School Name
OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2284678600
Graduation Year
2017 (9 years ago)
PAC ID
6608107164
Group Practice PAC ID
8022237015
Professional Enrollment ID
I20230823002357
Address ID
MS395201658BA149XXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

747 EMERGENCY MEDICINE in OK

Provider Addresses for DR. EBENEZER SAMPONG (DO)

  • 9012 S. College Ave.

    Unit 2008

    Tulsa, OK 74137

    Phone: (918) 671-2813

    Type: Location

  • Beach 74th Street, The Sands, Arverne By The Sea, Queens, New York, 11692, United States

    ARVERNE, NY 116921268

    Phone: (918) 671-2813

    Type: Mailing

  • 12027 PARC AUX CHENES

    GULFPORT, MS 395034570

    Phone: (918) 671-2813

    Type: Mailing

  • Merit Health Wesley, 5001, Hardy Street, Hattiesburg, Lamar County, Mississippi, 39402, United States

    HATTIESBURG, MS 39402

    Phone: (601) 296-3963

    Type: Location

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: 2023-08-23

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230823002357IEmergency MedicineMSTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making4949$0
99284Emergency department visit with moderate level of medical decision making3737$0
99291Critical care, first 30-74 minutes1918$0
View full utilization report →

Insurance plans in this area (ZIP 74137)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022237015View full group profile
NameSpecialtyState
Nurse PractitionerMS
Nurse PractitionerMS
Emergency Medicine, Internal MedicineLA
Physician AssistantMS
Nurse PractitionerLA
Nurse PractitionerGA
Emergency MedicineLA
Nurse PractitionerLA
Emergency Medicine, Family PracticeLA
-MS

Reviews

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Frequently asked questions

Does DR. EBENEZER SAMPONG (DO) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. EBENEZER SAMPONG (DO) uses 1093246613.
Can I rely on DR. EBENEZER SAMPONG (DO) being an active provider?
As of the registry snapshot, DR. EBENEZER SAMPONG (DO) is marked active.
What is DR. EBENEZER SAMPONG (DO) best known for clinically?
Directory data describes DR. EBENEZER SAMPONG (DO) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. EBENEZER SAMPONG (DO) based?
DR. EBENEZER SAMPONG (DO) is tied to Tulsa, Oklahoma in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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