1. Home
  2. Directory
  3. Oklahoma
  4. Broken Arrow
  5. Chiropractor
  6. NPI Profile

DR. SAMUEL DISKERUD
NPI 1689459208
Chiropractor in Broken Arrow, OK

Active since August 30, 2023PECOS Enrolled
900 W KENOSHA ST, BROKEN ARROW, OK 74012(918) 251-8889 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Samuel Diskerud NPPES

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

DR. SAMUEL DISKERUD (NPI 1689459208) is an individual chiropractor in Broken Arrow, Oklahoma, licensed in Oklahoma (4565) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS and is a graduate of Logan College Of Chiropractic (2023).

NPPES Registry Identity

NPI1689459208
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. SAMUEL DISKERUD
Location Address900 W KENOSHA STBroken Arrow, OK 74012-8917
Mailing Address900 W Kenosha StBroken Arrow, OK 74012-8917 · (918) 251-8889
Phone(918) 251-8889
Sole ProprietorNo
Medical School CMSLogan College Of ChiropracticGraduated 2023
Enumeration DateAugust 30, 2023
Last NPPES UpdateFebruary 23, 2026
NPPES CertifiedFebruary 23, 2026
✔ NPI 1689459208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in OK · 4565
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
900 W KENOSHA ST, Broken Arrow, OK 74012
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Diskerud is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5597119776
PECOS Enrollment IDI20230921001189
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 Samuel Diskerud reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dr. John K. Whitham, PC
Same address
Clinic/Center
900 W KENOSHA ST
Broken Arrow, OK 74012
  • Reassigned Medicare billing, Oklahoma enrollment
  • 2 clinicians in this Medicare group
NPI 1568693919 (918) 251-8889

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

Other Providers at the Same Location NPPES 3

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

DR. JOHN KENTON WHITHAM D.C.
Chiropractor
900 W KENOSHA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 251-8889
DR. DUSTIN A THOMAS DC
Chiropractor
900 W KENOSHA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 251-8889
DR. JOHN K. WHITHAM, PC
Clinic/Center
900 W KENOSHA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 251-8889

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 Samuel Diskerud's NPI number?

The NPI number for Samuel Diskerud is 1689459208. It was assigned to this individual provider in the NPPES registry on August 30, 2023.

Where is Samuel Diskerud located?

Samuel Diskerud practices at 900 W Kenosha St, Broken Arrow, OK 74012. The listed phone number is (918) 251-8889.

What is Samuel Diskerud's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Samuel Diskerud enrolled in Medicare?

Yes. Samuel Diskerud is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Diskerud's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Diskerud reassigns Medicare benefits to Dr. John K. Whitham, PC (Broken Arrow, 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 Samuel Diskerud's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Diskerud accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Samuel Diskerud 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 Samuel Diskerud was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.