DR. ROGER JOHN CHARBONEAU D.O.
NPI 1609862689
Orthopaedic Surgery - Sports Medicine in Ada, OK

Q: What is Roger Charboneau's NPI number?

The NPI number for Roger Charboneau is 1609862689. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Q: What is Roger Charboneau's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Roger Charboneau was last updated on August 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment

1921 STONECIPHER DR, ADA, OK 74820(580) 559-0510(580) 272-2715 Get Directions Write a Review

NPPES record last updated: August 10, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Roger John Charboneau D.o. NPPES

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

DR. ROGER JOHN CHARBONEAU D.O. (NPI 1609862689) is an individual sports medicine provider in Ada, Oklahoma, licensed in Oklahoma (4037) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Chickasaw Nation Medical Center, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1609862689

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDR. ROGER JOHN CHARBONEAUCredential: D.O.

Location Address1921 STONECIPHER DRAda, OK 74820-3439

Mailing Address1921 Stonecipher DrAda, OK 74820-3439 · (580) 559-0510 · Fax (580) 272-2715

Phone(580) 559-0510

Fax(580) 272-2715

Sole ProprietorYes

Medical School CMSOtherGraduated 1998

Enumeration DateSeptember 23, 2005

Last NPPES UpdateAugust 10, 2016

✔ NPI 1609862689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in OK · 4037

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

1921 STONECIPHER DR, Ada, OK 74820

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Other Identifiers 6

Medicaid200009440AOK

Medicare ID-Type Unspecified248323303OK

OtherP00212246OK · Railroad Medicare

Medicare UPINH89646OK

Other611692300OK · Owcp

Medicare OSCAR/certification248323303OK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Roger John Charboneau D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204891609

PECOS Enrollment IDI20090109000197

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.

Areas of Expertise CMS Part B claims 4

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

152 services116 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

79 services66 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

71 services43 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chickasaw Nation Medical Center

Acute Care Hospitals · Ada, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number370180

Location1921 Stonecipher BlvdAda, OK 74820 · Pontotoc County

Emergency services Birthing friendly

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.

TRAVIS L TEEL PA

Physician Assistant