NPIMap

Individual provider Active NPI

Jack Bryon Test Jr., MD

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1033648951
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33989 Issued in OK
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 748-7585
Fax
(918) 403-6352
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33989 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 748-7585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929003235 OK Practitioner - Internal Medicine 5193095792 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

608 NW 9TH St
Suite 3206
Oklahoma City, OK 73102-1068
Phone (405) 772-8605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

Merit-based Incentive Payment System (MIPS)

Final score
73.31 of 100Reported as group
Improvement activities
20
Cost
82.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
St. John Physicians, Inc. Internal Medicine Current Accepting new patients
Saints Medical Group, LLC Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Mark 5 Care Group, PLLC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
St. John Physicians, Inc CurrentSince Sep 20, 2021 Accepting new patients
Tulsa Hospital Medicine Physicians Group, LLC Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Healthfirst Physicians Management Services, Inc Internal Medicine Past Accepting new patients

Locations

1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556

1111 N Lee Ave
Ste 305
Oklahoma City, OK 73103
Phone (405) 272-4978

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 3206
Oklahoma City, OK 73102
Phone (405) 772-4338

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

4502 E 41st St
Tulsa, OK 74135
Phone (918) 579-2367

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Interoperability endpoints

  • Direct secure messaging: jtest171164@ahs.direct-ci.com
  • Direct secure messaging: jtest165692@direct-ehr-ssmhc.com

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1033648951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7585",
            "fax_number": "918-403-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7585",
            "fax_number": "918-403-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEST",
        "first_name": "JACK",
        "middle_name": "BRYON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "33989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.