DR. ANDREW HAWTHORN DODD (DO) – Adult Medicine Physician, NPI 1245804921

DR. ANDREW HAWTHORN DODD (DO) is a healthcare provider. based in Tahlequah, Oklahoma. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 7736 (OK). The NPI Number for DR. ANDREW HAWTHORN DODD (DO) is 1245804921

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREW HAWTHORN DODD (DO)
NPI
1245804921
Phone
(918) 458-3100
Address
100 S BLISS AVE
Enumeration Date
17 May 2021
Last Update Date
6 December 2024

Doctor Profile

Medical School Name
OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9182564800
Graduation Year
2021 (5 years ago)
PAC ID
1153795885
Group Practice PAC ID
5799698742
Professional Enrollment ID
I20230321001341
Address ID
OK743017953VI27371RDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,775 FAMILY PRACTICE in OK

Provider Addresses for DR. ANDREW HAWTHORN DODD (DO)

  • 100 S BLISS AVE

    TAHLEQUAH, OK 744642512

    Phone: (918) 458-3100

    Type: Mailing

  • 19600 E ROSS ST

    TAHLEQUAH, OK 744640545

    Phone: (918) 458-3100

    Type: Location

  • 27371 S 4410 RD

    VINITA, OK 743017953

    Phone: (918) 256-4800

    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: 2023-03-21

PECOS data refreshed: 2026-06-15

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
I20230321001341IFamily PracticeTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74464)

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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: 5799698742View full group profile

Reviews

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Frequently asked questions

What is DR. ANDREW HAWTHORN DODD (DO)'s NPI number?
DR. ANDREW HAWTHORN DODD (DO)'s NPI is 1245804921 — the number used across U.S. healthcare to identify this provider.
Would DR. ANDREW HAWTHORN DODD (DO) appear as active to a payer?
You can treat DR. ANDREW HAWTHORN DODD (DO) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. ANDREW HAWTHORN DODD (DO)?
DR. ANDREW HAWTHORN DODD (DO) is associated with Adult Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. ANDREW HAWTHORN DODD (DO)?
Directory geography for DR. ANDREW HAWTHORN DODD (DO) centers on Tahlequah, Oklahoma.
When was this NPI issued?
Enumeration for DR. ANDREW HAWTHORN DODD (DO) is noted as May 17, 2021 where the registry provides it.

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