Individual provider Active NPI

Daniel J Bancroft, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1114547825
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7410 Issued in OK
Practice address
7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone
(918) 710-4200
Fax
(918) 403-6311
NPI assigned
Apr 22, 2020
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 7410 OK Primary

Addresses

Primary practice location

7501 Riverside Pkwy
Tulsa, OK 74136-5056

Mailing address

7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone (918) 710-4200

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
I20220711003357 OK Practitioner - Family Practice 9830579630 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7410OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Mar 17, 2022 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Nov 5, 2024 Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Mar 17, 2022 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Aug 31, 2023 Accepting new patients
Hospital Care Consultants, Inc CurrentSince Jul 1, 2023 Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100

905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1114547825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCROFT",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.