NPIMap

Individual provider Active NPI

Jay Kevin Johnson, D.O.

  • Neurology Physician
  • Tulsa, OK
National Provider Identifier
1043224264
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2533 Issued in OK
Practice address
802 S Jackson Ave Ste 420
Tulsa, OK 74127-9059
Phone
(918) 743-2882
Fax
(918) 745-0323
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2533 OK Primary

Addresses

Primary practice location

802 S Jackson Ave Ste 420
Tulsa, OK 74127-9059

Mailing address

5310 E 31St St FL 13
Tulsa, OK 74135-5018
Phone (918) 561-5701

Other identifiers 2

IdentifierTypeStateIssuer
369701YM2YOtherOKMEDICARE
100137280BMedicaidOK

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
I20050609000415 OK Practitioner - NeurologyPractitioner - Psychiatry 8729021803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
University of Oklahoma College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians

Practice addresses (Care Compare)

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-5701

Hospital & facility affiliations

  • Oklahoma State University Medical Center Hospital, Tulsa, OK, CCN 370078
  • Cleveland Area Hospital Hospital, Cleveland, OK, CCN 371320
  • Northeastern Health System Hospital, Tahlequah, OK, CCN 370089

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
77.78
Promoting interoperability
99
Improvement activities
40
Cost
73.95

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Northeastern Health System CurrentSince Aug 20, 2014 Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Northeastern Health System CurrentSince Aug 20, 2014 Accepting new patients
Tulsa CT LLC Past Accepting new patients
Osumc Professional Services LLC Past Accepting new patients

Locations

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

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

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

Dept 2563
Tulsa, OK 74182

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

2401 Southwest Blvd
Tulsa, OK 74107

Interoperability endpoints

  • Direct secure messaging: jjohnson78789@direct.saintfrancis.com

Organizations & group practices 6

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 6

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1043224264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST FL 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 S JACKSON AVE STE 420",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279059",
            "telephone_number": "918-743-2882",
            "fax_number": "918-745-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAY",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "2533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "369701YM2Y",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100137280B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.