Individual provider Active NPI

Kenneth E Calabrese, DO

  • Nephrology Physician
  • Tulsa, OK
National Provider Identifier
1073601175
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
1653 Issued in OK
Practice address
6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806
Phone
(918) 582-3154
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 1653 OK Primary

Addresses

Primary practice location

6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806

Mailing address

6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806
Phone (918) 582-3154

Other practice location 1

802 S Jackson Ave Ste 301
Tulsa, OK 74127-9057
Phone (918) 631-8500

Other identifiers 1

IdentifierTypeStateIssuer
100146670AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110523000068 OK Practitioner - Nephrology 4385639020 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1653OKMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Physicians of Tulsa, Inc. Nephrology CurrentSince Jul 1, 1966 Accepting new patients
Osteopathic Physicians of Tulsa, Inc Nephrology Past Accepting new patients

Locations

215 S Brady St
Claremore, OK 74017
Phone (918) 283-2946

Dept 2761
Tulsa, OK 74182
Phone (918) 582-3154

6465 S Yale Ave
#401401
Tulsa, OK 74136
Phone 9185823154383

6465 S Yale Ave
Ste 401
Tulsa, OK 74136
Phone (918) 561-6141

802 S Jackson Ave
Ste 301
Tulsa, OK 74127
Phone (918) 582-3154

Interoperability endpoints

  • Direct secure messaging: kennethcalabrese@nst.allscriptsdirect.net

Organizations & group practices 2

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073601175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-582-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-582-3154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 S Jackson Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741279057",
            "country_code": "US",
            "telephone_number": "918-631-8500",
            "fax_number": "918-631-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100146670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.