Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeremy Theisen, MD

Individual provider Diagnostic Radiology Physician · NPI 1881954501

Jeremy Theisen, MD is a Diagnostic Radiology in Ponca City, Oklahoma. Qualified in 2012, 14 years ago. Practices with Capital Health Multispecialty Group, a 340-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Hawaii, New Jersey and Oklahoma.

Years since qualifying
14
Licensed in
HI, NJ, OK
In the registry since
2012
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1900 N 14th St
Ponca City, OK 74601-2035
Phone: (580) 765-0575
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1 Capital Way, Pennington, NJ 08534-2520 — (609) 303-4000
  • 310 Salem Woodstown Rd, Salem, NJ 08079-2064 — (856) 339-6054
  • 750 Brunswick Ave, Trenton, NJ 08638-4143 — (609) 394-6000
  • 920 Sl Young Blvd, Oklahoma City, OK 73104-5036 — (405) 271-5963
  • 920 Sl Young Blvd, Oklahoma City, OK 73104-5036 — (405) 271-5963

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 29296 (OK)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD-23144 (HI)
Internal Medicine Physician Taxonomy 207R00000X · Licence 29296 (OK)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 25IA12501900 (NJ)

Record details

NPI number1881954501
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 29, 2012
Last updated in NPPESSeptember 23, 2025
Certification dateSeptember 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Capital Health Multispecialty Group — 340 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations20 on file with Medicare

Other providers in Ponca City