Individual provider Active NPI

Sujan Joshi, MD

  • Family Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1073741732
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26280 Issued in OK
Practice address
2617 S Elm PL
Broken Arrow, OK 74012-7850
Phone
(918) 455-4541
Fax
(918) 449-9743
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2628026 OK
Family Medicine Physician 207Q00000X 26280 OK Primary

Addresses

Primary practice location

2617 S Elm PL
Broken Arrow, OK 74012-7850

Mailing address

1145 S Utica Ave Ste 110
Tulsa, OK 74104-4013
Phone (918) 579-3825

Other identifiers 2

IdentifierTypeStateIssuer
200039950AMedicaidOK
200277830AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000441 OK Practitioner - Family Practice 1557536976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

2617 S Elm PL
Suite 100
Broken Arrow, OK 74012-7850
Phone (918) 455-4541

Hospital & facility affiliations

  • Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
  • Vitalcaring Group Home health agency, Tulsa, OK, CCN 377787
  • Enhabit Home Health of Northeast Oklahoma Home health agency, Broken Arrow, OK, CCN 377572
  • Truheart Home Health Home health agency, Tulsa, OK, CCN 377615
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital Pryor Hospital, Pryor, OK, CCN 370015
  • Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2628026OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince May 1, 2017 Accepting new patients
Ahs Oklahoma Physician Group LLC Family Medicine CurrentSince May 1, 2017 Accepting new patients

Locations

2617 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 455-4541

2617 S Elm Pl
Ste 100
Broken Arrow, OK 74012
Phone (918) 455-4541

1301 NE 1st St
Ste 200
Pryor, OK 74361
Phone (918) 824-7767

562 S Elliott St
Pryor, OK 74361
Phone (918) 824-8000

1301 NE 1st St
Pryor, OK 74361
Phone (918) 824-6407

1301 NE 1st St
Ste 400
Pryor, OK 74361
Phone (918) 824-7714

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: sjoshi106948@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

Hospital & facility affiliations 9

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1073741732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3825",
            "fax_number": "918-579-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127850",
            "telephone_number": "918-455-4541",
            "fax_number": "918-449-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSHI",
        "first_name": "SUJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2628026",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200039950A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200277830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.