Oklahoma Pain Treatment Centers – Interventional Pain Medicine Physician, NPI 1013387810
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Oklahoma Pain Treatment Centers
1491 Health Center Pkwy
Yukon, OK 730996492
Phone: (405) 751-0011
Fax: (405) 751-7246
Type: Location
14100 PARKWAY COMMONS DR
SUITE 100
OKLAHOMA CITY, OK 731346103
Phone: (405) 286-9820
Fax: (405) 286-9813
Type: Mailing
PO BOX 654470
DALLAS, TX 752654470
Phone: (405) 751-0011
Fax: (405) 751-7246
Type: Mailing
13601 W MEMORIAL PARK DR STE 200
OKLAHOMA CITY, OK 731208375
Phone: (405) 751-0011
Fax: (405) 751-7246
Type: Location
2596 W Tecumseh Rd STE 116
Norman, OK 730698244
Phone: (405) 751-0011
Fax: (405) 751-7246
Type: Location
PO BOX 514
NORMAN, OK 730700514
Phone: (405) 751-0011
Fax: (405) 751-7246
Type: Mailing
14000 N PORTLAND AVE STE 101
OKLAHOMA CITY, OK 731344004
Phone: (405) 751-0011
Fax: (405) 751-7246
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: 2017-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (982 days ago).
Enrollment records
2
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| O20160705000766 | O | Clinic/Group Practice | OK | 2023-10-31 |
| O20170105001346 | O | Physician - Interventional Pain Management | OK | 2023-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 73099)
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