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BRIAN SPROUSE MD
NPI 1326429804
Emergency Medicine in Bartlesville, OK

Active since June 10, 2015PECOS Enrolled
91.24/100
CMS Quality Rating
3500 E FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74006(918) 333-7200 Get Directions Write a Review

NPPES record last updated: October 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Brian Sprouse Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIAN SPROUSE MD (NPI 1326429804) is an individual emergency medicine provider in Bartlesville, Oklahoma, licensed in Illinois (125-067086) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326429804
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameBRIAN SPROUSECredential: MD
Location Address3500 E FRANK PHILLIPS BLVDBartlesville, OK 74006-2411
Mailing Address3500 E Frank Phillips BlvdBartlesville, OK 74006-2411 · (918) 333-7200
Phone(918) 333-7200
Sole ProprietorYes
Enumeration DateJune 10, 2015
Last NPPES UpdateOctober 19, 2021
NPPES CertifiedOctober 19, 2021
✔ NPI 1326429804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IL · 125-067086
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
3500 E FRANK PHILLIPS BLVD, Bartlesville, OK 74006
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Wellmark Health Plan of Iowa, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brian Sprouse Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Brian Sprouse reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shenandoah Medical Center
276 mi
Rural Health
802 ILLINOIS ST
Sidney, IA 51652
  • Reassigned Medicare billing, Iowa enrollment
  • Also billed through NPI 1184621096 (Iowa)
  • 91 clinicians in this Medicare group
NPI 1700941648 (712) 374-6005

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
55 services55 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74006 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.24/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.13
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMBER NACOLE ROBERTS APRN
Nurse Practitioner
3500 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74006
Washington County (918) 333-7200
NATALIE J GILBERT DO
Emergency Medicine
3500 E FRANK PHILLIPS BLVD, ER DEPT
BARTLESVILLE, OK 74006
Washington County (918) 333-7200
JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC
Rehabilitation Unit
3500 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74006
Washington County (918) 333-7200
DR. GERALD GEORGE REED D.O.
Internal Medicine
3500 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74006
Washington County (918) 333-7200
MS. ABBY M WOOD R.D.
Dietitian, Registered
3500 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74006
Washington County (918) 331-1404
BAP L.L.P.
Anesthesiology
3500 E FRANK PHILLIPS BLVD, JPMC ANESTHESIA DEPT
BARTLESVILLE, OK 74006
Washington County (918) 331-1555
JENNIFER MCIVER RD, LD
Dietitian, Registered
3500 E FRANK PHILLIPS BLVD, JPMC
BARTLESVILLE, OK 74006
Washington County (918) 331-1341
PAIN RELIEF SPECIALISTS
Anesthesiology
3500 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74006
Washington County (405) 594-5094

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brian Sprouse's NPI number?

The NPI number for Brian Sprouse is 1326429804. It was assigned to this individual provider in the NPPES registry on June 10, 2015.

Where is Brian Sprouse located?

Brian Sprouse practices at 3500 E Frank Phillips Blvd, Bartlesville, OK 74006. The listed phone number is (918) 333-7200.

What is Brian Sprouse's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Brian Sprouse enrolled in Medicare?

Yes. Brian Sprouse is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brian Sprouse's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Sprouse reassigns Medicare benefits to Shenandoah Medical Center (Sidney, IA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brian Sprouse's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brian Sprouse accept?

Health plans from Wellmark Health Plan of Iowa, Inc. list Brian Sprouse as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brian Sprouse was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.