Jeremy Theisen, MD - Medicare Diagnostic Radiology in Ponca City, OK

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Jeremy Theisen, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Ponca City, Oklahoma. He graduated from medical school in 2012 and has 14 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Capital Health Multispecialty Group, Arkansas Health Group, Alleviate Pain Specialists, West Valley Radiology Medical Group Inc, Lompoc Valley Medical Center, Inspira Health Network Medical Group Pc, Washington Radiologists Medical Group Inc, St Jude Radiology Medical Group Inc, Insight Chicago Inc, Stillwater Medical Center Authority, Stillwater Radiology Llc, Renaissance Medical Foundation, Universal Radiology Partners Of Nevada Llc, Renaissance Medical Foundation, Modesto Radiological Medical Group Inc, San Antonio Radiological Medical, Oklahoma Radiology Group P C, Nrhs Radiology Associates, Temple Faculty Practice Plan Inc and his current practice location is 1900 N 14th St, Ponca City, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (580) 765-0575.

Jeremy Theisen is licensed to practice in Oklahoma (license number 29296) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1881954501.

Contact Information

Jeremy Theisen, MD
1900 N 14th St,
Ponca City, OK 74601-2035
(580) 765-0575
Not Available

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Physician's Profile

Full NameJeremy Theisen
GenderMale
SpecialityDiagnostic Radiology
Experience14 Years
Location1900 N 14th St, Ponca City, Oklahoma
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jeremy Theisen graduated from medical school in 2012
  NPI Data:
  • NPI Number: 1881954501
  • Provider Enumeration Date: 05/29/2012
  • Last Update Date: 09/23/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 1355571746
  • Enrollment ID: I20250804004080

Medical Identifiers

Medical identifiers for Jeremy Theisen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1881954501NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology MD-23144 (Hawaii)Secondary
207R00000XInternal Medicine 29296 (Oklahoma)Secondary
2085R0202XRadiology - Diagnostic Radiology 29296 (Oklahoma)Primary
2085R0202XRadiology - Diagnostic Radiology 25IA12501900 (New Jersey)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Stillwater Medical CenterStillwater, OKHospital
Ponca City Medical CenterPonca city, OKHospital
O U Medical CenterOklahoma city, OKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Capital Health Multispecialty Group1850689894342
Arkansas Health Group7911802079669
Alleviate Pain Specialists28608372674
West Valley Radiology Medical Group Inc165826662242
Lompoc Valley Medical Center973927559591
Inspira Health Network Medical Group Pc4880797570244
Washington Radiologists Medical Group Inc630592724567
St Jude Radiology Medical Group Inc721483800264
Insight Chicago Inc2860894706140
Stillwater Medical Center Authority2365353794166
Stillwater Radiology Llc11533485782
Renaissance Medical Foundation1153409867173
Universal Radiology Partners Of Nevada Llc579929525969
Renaissance Medical Foundation1153409867173
Modesto Radiological Medical Group Inc206230023998
San Antonio Radiological Medical832503594256
Oklahoma Radiology Group P C903210168862
Nrhs Radiology Associates266855573166
Temple Faculty Practice Plan Inc03455887111326

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeremy Theisen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jeremy Theisen, MD
1900 N 14th St,
Ponca City, OK 74601-2035

Ph: (580) 765-0575		Jeremy Theisen, MD
1900 N 14th St,
Ponca City, OK 74601-2035

Ph: (580) 765-0575

Reviews and Comments


Radiology Doctors in Ponca City, OK


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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