NORTHERN OKLAHOMA DERMATOLOGY – Dermatology Physician, NPI 1326823485

NORTHERN OKLAHOMA DERMATOLOGY is a healthcare provider. based in Bartlesville, Oklahoma. specializing in Dermatology Physician. The NPI Number for NORTHERN OKLAHOMA DERMATOLOGY is 1326823485

Main info

Organization
Name
NORTHERN OKLAHOMA DERMATOLOGY
NPI
1326823485
Phone
(918) 214-8888
Address
309 SE FRANK PHILLIPS BLVD
Authorized Official
NICHOLAS ALBERT MIETUS PRESIDENT/ OWNER PA
Enumeration Date
28 August 2023
Last Update Date
8 May 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for NORTHERN OKLAHOMA DERMATOLOGY

  • 309 SE FRANK PHILLIPS BLVD

    BARTLESVILLE, OK 740033643

    Phone: (918) 214-8888

    Fax: (918) 214-8887

    Mailing address matches the actual address.

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: 2023-11-15

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
O20231115001980OClinic/Group PracticeOKTBD

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 74003)

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Reviews

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Frequently asked questions

How is NORTHERN OKLAHOMA DERMATOLOGY identified in CMS data?
CMS-hosted NPPES data lists NORTHERN OKLAHOMA DERMATOLOGY with NPI 1326823485.
Does the file indicate NORTHERN OKLAHOMA DERMATOLOGY is practicing under active NPI?
Directory data currently reports NORTHERN OKLAHOMA DERMATOLOGY as active.
What is NORTHERN OKLAHOMA DERMATOLOGY's specialty?
The listing groups NORTHERN OKLAHOMA DERMATOLOGY with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is NORTHERN OKLAHOMA DERMATOLOGY based?
NORTHERN OKLAHOMA DERMATOLOGY is tied to Bartlesville, Oklahoma in the data we show; additional addresses may exist on the full record.
Why does NORTHERN OKLAHOMA DERMATOLOGY have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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