NPIMap

Individual provider Active NPI

Thomas Kelly Tkach, MD

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1093713331
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
17380 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 230-9000
Fax
(405) 230-9477
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 17380 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 230-9000

Other identifiers 2

IdentifierTypeStateIssuer
100095900AMedicaidOK
200022041OtherOKRAILROAD MEDICARE

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
I20091203000205 OK Practitioner - Orthopedic Surgery 6901847136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Oklahoma College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
McBride Clinic Orthopedic Hospital, LLCGroup PAC ID 3678514809, 100 clinicians

Practice addresses (Care Compare)

2230 N Perkins Rd
Stillwater, OK 74075-3076
Phone (405) 780-9919

9600 Broadway Ext
McBride Orthopedic Hospital
Oklahoma City, OK 73114-7408
Phone (405) 486-2100

Hospital & facility affiliations

  • Entrust Home Health Home health agency, Oklahoma City, OK, CCN 377639
  • Amedisys Home Health Home health agency, Oklahoma City, OK, CCN 377642
  • Elara Caring XX Home health agency, Oklahoma City, OK, CCN 377648
  • Elara Caring Xxiv Home health agency, Lawton, OK, CCN 377660
  • Elara Caring IV Home health agency, Chickasha, OK, CCN 377690
  • McBride Orthopedic Hospital Hospital, Oklahoma City, OK, CCN 370222
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049
  • SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
  • Duncan Regional Hospital, Inc Hospital, Duncan, OK, CCN 370023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement124
Knee replacement172
Lower limb (leg) arthroscopy (minimally invasive joint repair)12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McBride Clinic Orthopedic Hospital, LLC Orthopaedic Surgery CurrentSince Feb 1, 2011 Accepting new patients
McBride Clinic Inc Orthopaedic Surgery Past Accepting new patients
McBride Clinic Orthopedic Hospital, LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1110 N Lee Ave
Oklahoma City, OK 73103
Phone (405) 232-0341

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Interoperability endpoints

  • Direct secure messaging: thomas.tkach@moh.eclinicaldirectplus.com

Organizations & group practices 4

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 10

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1093713331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACH",
        "first_name": "THOMAS",
        "middle_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "17380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095900A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200022041",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.