Max Brian Swenson Jr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA15 Issued in OK

Practice address

8801 S. 101St East Ave
Tulsa, OK 74133

Phone

(918) 294-6911

Fax

(918) 294-4579

NPI assigned

Nov 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Diagnostic Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Tulsa, OK
  • NPI 1427049956
  NPD (past)
• Southcrest Emergency Physicians PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tulsa, OK
  • NPI 1205816048
  NPD (past)
• Sterling Emergency Services of Oklahoma, Inc.

  • Nurse Practitioner
  • Tulsa, OK
  • NPI 1366480295
  NPD (past)

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1033100268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9641 S. SANDUSKY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374812",
            "telephone_number": "918-294-4779",
            "fax_number": "918-294-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 S. 101ST EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-294-6911",
            "fax_number": "918-294-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "MAX",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100110300B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970021922",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Rae Sweet, RN
• Catrina Sweet
• Chandler Sweetwood
• Tristen Swengle, DPT
• Matthew L Swenson, M.D.
• Emma Swepston
• Ronald Lee Swetnam, RSS
• Casey Swift, O.D.
• Kairie Swift, CNP-FAMILY
• Saini Jay Swift

• Medical Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.