Individual provider Active NPI

Kim R Hauger, M.D.

  • Diagnostic Radiology Physician
  • Tulsa, OK
National Provider Identifier
1003803602
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15635 Issued in OK
Practice address
5801 E 41St St Ste 900
Tulsa, OK 74135-5631
Phone
(918) 747-4975
Fax
(918) 743-8552
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 15635 OK Primary

Addresses

Primary practice location

5801 E 41St St Ste 900
Tulsa, OK 74135-5631

Mailing address

PO Box 4930
Tulsa, OK 74159-0930
Phone (918) 747-4975

Other identifiers 3

IdentifierTypeStateIssuer
300019098OtherOKRAILROAD MEDICARE
100112790AMedicaidOK
300129676OtherOKRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413001483 OK Practitioner - Diagnostic Radiology 1658365473 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15365OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Consultants of Tulsa Inc Diagnostic Radiology CurrentSince Feb 12, 1990 Accepting new patients
Radiological Imaging of Oklahoma, L.L.C. Past Accepting new patients
Tulsa Radiology Associates Inc Diagnostic Radiology PastSince Jul 1, 2009 Accepting new patients
Springer Clinic Inc Past Accepting new patients

Locations

4111 S Darlington Ave
Ste 700
Tulsa, OK 74135
Phone (918) 743-8943

3010 S Harvard Ave
Ste 220
Tulsa, OK 74114
Phone (918) 743-8240

5801 E 41st St
Ste 900
Tulsa, OK 74135
Phone (918) 743-8838

Interoperability endpoints

  • Direct secure messaging: kim.hauger@direct.stjohnhealthsystem.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1003803602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4930",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741590930",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 E 41ST ST STE 900",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355631",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGER",
        "first_name": "KIM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "15635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300019098",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112790A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300129676",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.