RICHARD J HELTON
NPI 1972545820
Family Medicine in Coalgate, OK

Q: What is Richard Helton's NPI number?

The NPI number for Richard Helton is 1972545820. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Q: What is Richard Helton'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 Richard Helton was last updated on June 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 June 12, 2006PECOS EnrolledAccepts Medicare Assignment

27.89/100

CMS Quality Rating

108 W OHIO, COALGATE, OK 74538(580) 927-2334(580) 927-9941 Get Directions Write a Review

NPPES record last updated: June 18, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Richard J Helton NPPES

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

RICHARD J HELTON (NPI 1972545820) is an individual family medicine provider in Coalgate, Oklahoma, licensed in Oklahoma (2096) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Alliancehealth Durant, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (1980).

NPPES Registry Identity

NPI1972545820

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameRICHARD J HELTON

Location Address108 W OHIOCoalgate, OK 74538-2827

Mailing AddressPo Box 345Coalgate, OK 74538-0345 · (580) 927-2334 · Fax (580) 927-9941

Phone(580) 927-2334

Fax(580) 927-9941

Sole ProprietorYes

Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 1980

Enumeration DateJune 12, 2006

Last NPPES UpdateJune 18, 2015

✔ NPI 1972545820 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 · 2096

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 ListedClinic/Center · Rural HealthTaxonomy 261QR1300X · License 2096 (OK)

108 W OHIO, Coalgate, OK 74538

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Other Identifiers 7

Medicaid100089840AOK

Medicaid100741130AOK

Medicaid100741130BOK

Medicaid100741130COK

Medicare PIN800522052OK

Medicare UPINE15971OK

Medicare OSCAR/certification373823OK

Accepted Insurance

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

Richard J Helton 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 ID2769370113

PECOS Enrollment IDI20040723000951

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 24

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.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

1,605 services134 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

346 services109 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.

185 services57 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

178 services72 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

162 services38 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

159 services121 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

149 services119 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

120 services95 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

117 services84 patients

Evaluation of neuropsychological test, first hour 96132

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

105 services79 patients

Administration of psychological or neuropsychological test by technician, first 30 minutes 96138

This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.

105 services79 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

87 services39 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

78 services78 patients

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.

67 services46 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

46 services20 patients

Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow G0181

This service involves a physician overseeing your care while you receive Medicare-covered services from a home health agency. The care you're receiving is complex and involves various disciplines. The physician isn't physically present but regularly supervises your treatment to ensure optimal health outcomes.

42 services35 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

33 services16 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

32 services30 patients

Ultrasound study of arm and leg arteries 93922

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

28 services27 patients

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.

25 services18 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services13 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

15 services12 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

15 services15 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Alliancehealth Durant

Acute Care Hospitals · Durant, OK

1/5 CMS rating

OwnershipProprietary

CMS Certification Number370014

Location1800 University BoulevardDurant, OK 74702 · Bryan County

Emergency services Birthing friendly

Mercy Hospital Ada

Acute Care Hospitals · Ada, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370020

Location430 North Monte VistaAda, OK 74820 · Pontotoc County

Emergency services Birthing friendly

Mcalester Regional Health Center

Acute Care Hospitals · Mcalester, OK

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number370034

Location1 Clark Bass BoulevardMcalester, OK 74501 · Pittsburg County

Emergency services Birthing friendly

Atoka County Medical Center

Critical Access Hospitals · Atoka, OK

OwnershipGovernment - Hospital District or Authority

CMS Certification Number371300

Location1590 West Liberty RoadAtoka, OK 74525 · Atoka County

Emergency services

Coal County General Hospital, Inc.

Critical Access Hospitals · Coalgate, OK

OwnershipProprietary

CMS Certification Number371319

Location6 North CovingtonCoalgate, OK 74538 · Coal County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74538 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.

27.89/100

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

Individually scored

Quality

Improvement Activities

Cost

18.16

Referred Medical Equipment & Supplies CMS DME claims 34

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

7 suppliers78 claims266 services$6.67 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

2 suppliers29 claims30 services$2.93 avg. paid by Medicare

Spring-powered device for lancet, each A4258

DME-Other DME · category DE000N

3 suppliers13 claims13 services$1.82 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers46 claims101 services$1.20 avg. paid by Medicare

Urinary catheter anchoring device, adhesive skin attachment, each A4333

DME-Orthotic Devices · category DF000N

1 supplier16 claims192 services$1.72 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier13 claims15 services$5.87 avg. paid by Medicare

Collagen based wound filler, dry form, sterile, per gram of collagen A6010

DME-Medical/Surgical Supplies · category DA023N

1 supplier30 claims1,113 services$30.02 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196

DME-Medical/Surgical Supplies · category DA023N

1 supplier24 claims900 services$7.01 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing A6197

DME-Medical/Surgical Supplies · category DA023N

1 supplier18 claims493 services$15.74 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches A6199

DME-Medical/Surgical Supplies · category DA023N

1 supplier13 claims698 services$5.11 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

5 suppliers24 claims49 services$1.93 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 suppliers13 claims13 services$68.30 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

7 suppliers12 claims12 services$23.73 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers13 claims13 services$20.64 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

7 suppliers21 claims84 services$3.22 avg. paid by Medicare

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

6 suppliers12 claims12 services$69.55 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

5 suppliers66 claims68 services$66.89 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

11 suppliers165 claims171 services$19.47 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers24 claims24 services$49.07 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers14 claims14 services$924.23 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers41 claims41 services$7.04 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers28 claims28 services$43.63 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

2 suppliers11 claims11 services$50.67 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

12 suppliers249 claims253 services$104.74 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

5 suppliers54 claims57 services$35.84 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

3 suppliers39 claims2,340 services$4.15 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

9 suppliers46 claims8,902 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

7 suppliers50 claims6,360 services$0.08 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

4 suppliers56 claims3,366 services$0.74 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

1 supplier13 claims585 services$0.16 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

4 suppliers66 claims66 services$25.39 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

3 suppliers12 claims12 services$28.88 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

6 suppliers30 claims30 services$201.17 avg. paid by Medicare

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

DME-Other DME · category DE000N

11 suppliers95 claims95 services$22.78 avg. paid by Medicare

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

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 Richard Helton's NPI number?

The NPI number for Richard Helton is 1972545820. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Richard Helton located?

Richard Helton practices at 108 W Ohio, Coalgate, OK 74538. The listed phone number is (580) 927-2334.

What is Richard Helton's specialty?

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

Is Richard Helton enrolled in Medicare?

Yes. Richard Helton 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 Richard Helton accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, CommunityCare, Medica, Mending Health and UnitedHealthcare list Richard Helton 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 Richard Helton affiliated with any hospitals?

According to CMS data, Richard Helton is affiliated with Alliancehealth Durant, Mercy Hospital Ada, Mcalester Regional Health Center, Atoka County Medical Center and Coal County General Hospital, Inc..

When was this NPI record last updated?

The NPPES record for Richard Helton was last updated on June 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.