Individual provider Active NPI

Augustus L Caine Jr., M.D.

  • Cardiovascular Disease Physician
  • Owasso, OK
National Provider Identifier
1043657844
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
39728 Issued in OK
Practice address
12455 E 100TH St N Ste 260
Owasso, OK 74055-4676
Phone
(918) 274-5560
Fax
(918) 403-6336
NPI assigned
Jun 3, 2013
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Cardiovascular Disease Physician 207RC0000X 2019014502 MO
Cardiovascular Disease Physician 207RC0000X 39728 OK Primary

Addresses

Primary practice location

12455 E 100TH St N Ste 260
Owasso, OK 74055-4676

Mailing address

12455 E 100TH St N Ste 260
Owasso, OK 74055-4676
Phone (918) 274-5560

Other practice location 1

100 Mercy Way Ste 320
Joplin, MO 64804-4524
Phone (417) 781-5387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190808004104 MO Practitioner - Cardiovascular Disease (Cardiology) 7012208358 Reassigns benefits to 1 organization
I20231221003629 OK Practitioner - Cardiovascular Disease (Cardiology) 7012208358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1000 W Boise Circle
Emergency Room
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jan 15, 2024 Accepting new patients
St. John Physicians, Inc. Cardiovascular Disease CurrentSince Jan 15, 2024 Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients
Tulsa Pain Consultants, Inc PastSince May 7, 2024 Accepting new patients

Locations

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

Networks

  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 5

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

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1043657844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 260",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554676",
            "telephone_number": "918-274-5560",
            "fax_number": "918-403-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 260",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554676",
            "telephone_number": "918-274-5560",
            "fax_number": "918-403-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mercy Way Ste 320",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648044524",
            "country_code": "US",
            "telephone_number": "417-781-5387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAINE",
        "first_name": "AUGUSTUS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2019014502",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "39728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.