Individual provider Active NPI

Matthew Tandy, M.D.

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1104054469
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27250 Issued in OK
Practice address
4502 E 41St St
Tulsa, OK 74135-9923
Phone
(918) 660-3416
Fax
(918) 660-3426
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27250 OK Primary

Addresses

Primary practice location

4502 E 41St St
Tulsa, OK 74135-9923

Mailing address

4502 E 41St St
Tulsa, OK 74135-9923
Phone (918) 660-3416

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
I20151021003070 OK Practitioner - Pediatric Medicine 6305155995 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Sep 1, 2015 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

4444 E 41st St
Ste A
Tulsa, OK 74135
Phone (682) 303-0376

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

4502 E 41st St
Tulsa, OK 74135
Phone (918) 579-2367

Interoperability endpoints

  • Direct secure messaging: mtandy28352@ouhealth.direct-ci.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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1104054469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741359923",
            "telephone_number": "918-660-3416",
            "fax_number": "918-660-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741359923",
            "telephone_number": "918-660-3416",
            "fax_number": "918-660-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "27250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.