DR. DONALD M ELGIN MD
NPI 1790892529
Family Medicine in Ft. Gibson, OK

Q: What is Donald Elgin's NPI number?

The NPI number for Donald Elgin is 1790892529. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Q: What is Donald Elgin's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Elgin was last updated on June 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 25, 2006PECOS EnrolledAccepts Medicare Assignment

91.18/100

CMS Quality Rating

104 LONE OAK CIRCLE, FT. GIBSON, OK 74434(918) 478-2101(918) 478-6008 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Donald M Elgin Md NPPES

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

DR. DONALD M ELGIN MD (NPI 1790892529) is an individual family medicine provider in Ft. Gibson, Oklahoma, licensed in Oklahoma (11727) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Hospital Muskogee, and is a graduate of University Of Oklahoma College Of Medicine (1976).

NPPES Registry Identity

NPI1790892529

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DONALD M ELGINCredential: MD

Location Address104 LONE OAK CIRCLEFt. Gibson, OK 74434

Mailing AddressPo Box 1008Tahlequah, OK 74465-1008 · (918) 478-2101 · Fax (918) 478-6008

Phone(918) 478-2101

Fax(918) 478-6008

Sole ProprietorNo

Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1976

Enumeration DateAugust 25, 2006

Last NPPES UpdateJune 1, 2026

NPPES CertifiedJune 1, 2026

✔ NPI 1790892529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OK · 11727

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X · License 11727 (OK)

104 LONE OAK CIRCLE, Ft. Gibson, OK 74434

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Other Identifiers 3

Medicaid100123270AOK

Other107709001OK · Dmerc

Other80161083OK · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.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. Donald M Elgin Md 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 ID4486567237

PECOS Enrollment IDI20031107000698

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 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.

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

115 services48 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

44 services42 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Francis Hospital Muskogee

Acute Care Hospitals · Muskogee, OK

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370025

Location300 Rockefeller DriveMuskogee, OK 74401 · Muskogee County

Emergency services Birthing friendly

Northeastern Health System

Acute Care Hospitals · Tahlequah, OK

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number370089

Location1400 East Downing StreetTahlequah, OK 74465 · Cherokee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74434 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.

91.18/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

79.27

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 25

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers46 claims115 services$5.37 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

6 suppliers22 claims22 services$40.42 avg. paid by Medicare

Collagen dressing, sterile, size 16 sq. in. or less, each A6021

DME-Medical/Surgical Supplies · category DA023N

1 supplier21 claims433 services$20.00 avg. paid by Medicare

Hydrocolloid dressing, wound filler, paste, sterile, per ounce A6240

DME-Medical/Surgical Supplies · category DA023N

1 supplier13 claims78 services$11.75 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

10 suppliers30 claims30 services$93.44 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

8 suppliers47 claims70 services$39.59 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

7 suppliers14 claims14 services$63.64 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

13 suppliers27 claims27 services$19.17 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

8 suppliers23 claims23 services$17.81 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

13 suppliers62 claims196 services$2.81 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

8 suppliers18 claims18 services$13.31 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims360 services$4.16 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier21 claims15,305 services$0.38 avg. paid by Medicare

Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress E0303

DME-Hospital Beds · category DB000N

1 supplier12 claims12 services$147.68 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers43 claims44 services$20.81 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

2 suppliers23 claims23 services$100.85 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

1 supplier12 claims12 services$284.95 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers30 claims30 services$40.70 avg. paid by Medicare

Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar E0912

DME-Hospital Beds · category DB000N

1 supplier12 claims12 services$68.94 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers67 claims68 services$112.76 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier11 claims11 services$24.17 avg. paid by Medicare

Heavy duty wheelchair K0006

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$72.54 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

1 supplier11 claims11 services$11.17 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

5 suppliers51 claims51 services$203.56 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

3 suppliers12 claims12 services$23.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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 Donald Elgin's NPI number?

The NPI number for Donald Elgin is 1790892529. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Donald Elgin located?

Donald Elgin practices at 104 Lone Oak Circle, Ft. Gibson, OK 74434. The listed phone number is (918) 478-2101.

What is Donald Elgin's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Donald Elgin enrolled in Medicare?

Yes. Donald Elgin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Donald Elgin accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Donald Elgin 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.

Is Donald Elgin affiliated with any hospitals?

According to CMS data, Donald Elgin is affiliated with Saint Francis Hospital Muskogee and Northeastern Health System.

When was this NPI record last updated?

The NPPES record for Donald Elgin was last updated on June 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.