Jeremy Theisen, MD
Jeremy Theisen, MD is a Diagnostic Radiology Physician in Ponca City, OK, registered under NPI 1881954501. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1900 N 14TH ST, Ponca City, OK 74601. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 29296 | OK | Diagnostic Radiology Physician primary |
| MD-23144 | HI | Diagnostic Radiology Physician |
| 29296 | OK | Internal Medicine Physician |
| 25IA12501900 | NJ | Diagnostic Radiology Physician |
Licences are recorded in 3 states: OK, HI, NJ. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Diagnostic Radiology
- PAC ID
- 1355571746
Enrolled in Medicare 10 times, across 10 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Oklahoma | I20140304001840 | Practitioner - Diagnostic Radiology |
| Hawaii | I20230203001532 | Practitioner - Diagnostic Radiology |
| California | I20231113003179 | Practitioner - Diagnostic Radiology |
| Nevada | I20240509002323 | Practitioner - Diagnostic Radiology |
| Arkansas | I20240613003588 | Practitioner - Diagnostic Radiology |
| Texas | I20240911003963 | Practitioner - Diagnostic Radiology |
| New Jersey | I20250804004080 | Practitioner - Diagnostic Radiology |
| Mississippi | I20251009004519 | Practitioner - Diagnostic Radiology |
| Pennsylvania | I20251025000247 | Practitioner - Diagnostic Radiology |
| Illinois | I20251222001248 | Practitioner - Diagnostic Radiology |
Medicare enrolment is recorded as approved under the provider type Practitioner - Diagnostic Radiology. There are 10 separate enrolment records across 10 states (OK, HI, CA, NV, AR, TX, NJ, MS, PA, IL). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 3 states
This provider holds licences in 3 states: Hawaii, New Jersey and Oklahoma. The practice address on file is in Ponca City, OK, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 25IA12501900
- Specialty
- Diagnostic Radiology Physician
- Licence
- 29296
- Specialty
- Diagnostic Radiology Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Diagnostic Radiology covers
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NUCC Health Care Provider Taxonomy, code 2085R0202X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2085R0202X | Diagnostic Radiology Physician Diagnostic Radiology | 29296 | OK | primary |
| 2085R0202X | Diagnostic Radiology Physician Diagnostic Radiology | MD-23144 | HI | |
| 207R00000X | Internal Medicine Physician | 29296 | OK | |
| 2085R0202X | Diagnostic Radiology Physician Diagnostic Radiology | 25IA12501900 | NJ |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1881954501 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 29, 2012 |
| Last updated | Sep 23, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
1900 N 14TH ST Ponca City, OK 74601 (580) 765-0575 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 8 | 8 | 1 | 9 | 5 | 4 | 5 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 8 | 7 | 1 | 9 | 5 | 8 | 5 | 0 |
Sum = 69 · next multiple of 10 = 70 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.