Cavanal Medical Clinic – Family Medicine Physician, NPI 1578026571
Family Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Cavanal Medical Clinic
105 WALL ST
POTEAU, OK 749534433
Phone: (918) 635-3566
Fax: (918) 635-3568
Type: Mailing
1013, Dewey Avenue, Poteau, Le Flore County, Oklahoma, 74953, United States
POTEAU, OK 749534409
Phone: (918) 647-2929
Fax: (918) 647-2288
Type: Mailing
1013 Dewey Ave
Poteau, OK 749534409
Phone: (918) 647-2929
Fax: (918) 647-2288
Type: Location
104 S EAST BLVD
POTEAU, OK 74953
Phone: (918) 635-3576
Fax: (918) 635-3158
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2020-01-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (254 days ago).
Enrollment records
2
Earliest due date
2025-09-30
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 |
|---|---|---|---|---|
| O20060804000192 | O | Clinic/Group Practice | OK | TBD |
| O20200113000839 | O | Rural Health Clinic | OK | 2025-09-30 |
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 74953)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.