Individual provider Active NPI

Binh Thai Phung, D.O.

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1023339462
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5049 Issued in OK
Practice address
717 S Houston Ave Ste 400
Tulsa, OK 74127-9007
Phone
(918) 382-4600
Fax
(918) 382-3183
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5049 OK Primary

Addresses

Primary practice location

717 S Houston Ave Ste 400
Tulsa, OK 74127-9007

Mailing address

717 S Houston Ave Ste 400
Tulsa, OK 74127-9007
Phone (918) 382-4600

Other identifiers 1

IdentifierTypeStateIssuer
200342430AMedicaidOK

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
I20130820000061 OK Practitioner - Pediatric Medicine 3274775390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5049OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

Dept 2563
Tulsa, OK 74182

2401 Southwest Blvd
Tulsa, OK 74107

Interoperability endpoints

  • Direct secure messaging: binh.phung@direct.stjohnhealthsystem.com
  • Direct secure messaging: bphung50984@direct.saintfrancis.com

Organizations & group practices 3

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": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1023339462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279007",
            "telephone_number": "918-382-4600",
            "fax_number": "918-382-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279007",
            "telephone_number": "918-382-4600",
            "fax_number": "918-382-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "BINH",
        "middle_name": "THAI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "5049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200342430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.