MR. THOMAS A MAIBENCO MD
NPI 1639211386
Physical Medicine & Rehabilitation - Pain Medicine in Tahlequah, OK
About Mr. Thomas A Maibenco Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. THOMAS A MAIBENCO MD (NPI 1639211386) is an individual pain medicine provider in Tahlequah, Oklahoma, licensed in Oklahoma (35295) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Ofallon.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Thomas A Maibenco Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Thomas Maibenco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tahlequah, OK 74464
- Reassigned Medicare billing, Oklahoma enrollment
- 65 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TAHLEQUAH, OK 74464
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 Thomas Maibenco's NPI number?
The NPI number for Thomas Maibenco is 1639211386. It was assigned to this individual provider in the NPPES registry on February 12, 2007.
Where is Thomas Maibenco located?
Thomas Maibenco practices at 1500 E Downing St Ste 101, Tahlequah, OK 74464. The listed phone number is (918) 453-1234.
What is Thomas Maibenco's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.
Is Thomas Maibenco enrolled in Medicare?
Yes. Thomas Maibenco is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Thomas Maibenco's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Maibenco reassigns Medicare benefits to Northeastern Oklahoma Community Health Centers, Inc. (Tahlequah, OK). 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 Thomas Maibenco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Thomas Maibenco was last updated on March 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Mr. Thomas A Maibenco, MD · NPI 1639211386
Pain Medicine physician in Tahlequah, Oklahoma. Individual provider, active in the CMS NPPES registry since February 12, 2007.
## Identity
- **NPI:** 1639211386 (Entity type: Individual)
- **Enumerated:** February 12, 2007
- **Primary specialty:** Physical Medicine & Rehabilitation - Pain Medicine · taxonomy 2081P2900X
- **State license:** 35295 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 1500 E DOWNING ST STE 101, Tahlequah, OK 74464-3354
- **Phone:** (918) 453-1234
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Northeastern Oklahoma Community Health Centers, Inc. (NPI 1063188878, Tahlequah, OK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1639211386) · Data from the CMS NPPES public registry.