Active NPI
Barry Don Troutman, D.O.
- Family Medicine Physician
- Tulsa, OK
National Provider Identifier
1104910272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3123
- Practice address
- 4619 S Harvard Ave
Suite 102
Tulsa, OK 74135-2920 - Phone
- (918) 747-0900
- Fax
- (918) 747-0980
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3123 | OK | Primary |
Addresses
Primary practice location
4619 S Harvard Ave
Suite 102
Tulsa, OK 74135-2920
Mailing address
4619 S Harvard Ave
Suite 102
Tulsa, OK 74135-2921
Phone (918) 747-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100129870A | Medicaid | OK |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081118000599 | OK | Practitioner - Family Practice | 6204996424 | Practice locations: Tulsa, OK |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3123 | OK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Incorporated | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Broken Arrow, OK
- NPI 1215992235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1104910272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4619 S HARVARD AVE",
"address_2": "SUITE 102",
"city": "TULSA",
"state": "OK",
"postal_code": "741352921",
"telephone_number": "918-747-0900",
"fax_number": "918-747-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4619 S HARVARD AVE",
"address_2": "SUITE 102",
"city": "TULSA",
"state": "OK",
"postal_code": "741352920",
"telephone_number": "918-747-0900",
"fax_number": "918-747-0980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROUTMAN",
"first_name": "BARRY",
"middle_name": "DON",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "3123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100129870A",
"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 Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.