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 went to University Of Oklahoma College Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Allrad Pllc, Los Robles Radiologic Associates, Modesto Radiological Medical Group Inc, Nrhs Radiology Associates, Silicon Valley Diagnostic Imaging Inc, St Jude Radiology Medical Group Inc, Stillwater Radiology Llc, Hawaii Permanente Medical Group 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

Map and Direction




Physician's Profile

Full NameJeremy Theisen
GenderMale
SpecialityDiagnostic Radiology
Experience12 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 attended and graduated from University Of Oklahoma College Of Medicine in 2012
  NPI Data:
  • NPI Number: 1881954501
  • Provider Enumeration Date: 05/29/2012
  • Last Update Date: 03/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1355571746
  • Enrollment ID: I20140304001840

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
207R00000XInternal Medicine 29296 (Oklahoma)Secondary
2085R0202XRadiology - Diagnostic Radiology MD-23144 (Hawaii)Secondary
2085R0202XRadiology - Diagnostic Radiology 29296 (Oklahoma)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Stillwater Medical CenterStillwater, OKHospital
Ponca City Medical CenterPonca city, OKHospital
Norman RegionalNorman, OKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Allrad Pllc024448429326
Los Robles Radiologic Associates044631920654
Modesto Radiological Medical Group Inc206230023974
Nrhs Radiology Associates266855573155
Silicon Valley Diagnostic Imaging Inc549683851898
St Jude Radiology Medical Group Inc721483800247
Stillwater Radiology Llc11533485783
Hawaii Permanente Medical Group Inc7618880667541

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeremy Theisen allows following entities to bill medicare on his behalf.
Entity NameStillwater Radiology Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609911452
PECOS PAC ID: 1153348578
Enrollment ID: O20051025000959
Entity NameEagle Partners Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548450976
PECOS PAC ID: 9032205752
Enrollment ID: O20071011000078
Entity NameNrhs Radiology Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134316169
PECOS PAC ID: 2668555731
Enrollment ID: O20080213000018
Entity NameComanche County Hospital Authority Southwest Radiology
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194996447
PECOS PAC ID: 7113082009
Enrollment ID: O20090209000657
Entity NameAllrad Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821341884
PECOS PAC ID: 0244484293
Enrollment ID: O20130129000425
Entity NameModesto Radiological Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992747547
PECOS PAC ID: 2062300239
Enrollment ID: O20190116001638
Entity NameLos Robles Radiologic Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730157215
PECOS PAC ID: 0446319206
Enrollment ID: O20190314000407
Entity NameRenaissance Radiology Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275181455
PECOS PAC ID: 0345571881
Enrollment ID: O20191017000730
Entity NameSilicon Valley Diagnostic Imaging Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629265806
PECOS PAC ID: 5496838518
Enrollment ID: O20210706002856
Entity NameFocus Medical Imaging
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528299989
PECOS PAC ID: 6406999259
Enrollment ID: O20220331002161
Entity NameSt Jude Radiology Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649349705
PECOS PAC ID: 7214838002
Enrollment ID: O20220503002319
Entity NamePlacerville Radiology Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700847621
PECOS PAC ID: 0143382374
Enrollment ID: O20230601000827
Entity NameRadiology Consultants Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285735571
PECOS PAC ID: 9032195128
Enrollment ID: O20231104000729
Entity NameAlleviate Pain Specialists
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932971439
PECOS PAC ID: 2860837267
Enrollment ID: O20240226000797

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


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

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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