John C. Andrus, MD
Individual provider Active NPI Geriatric Psychiatry Physician · Oklahoma City, OK
NPI 1124052089 · NPPES record last updated Jul 21, 2017
Key facts
- NPI
- 1124052089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Psychiatry Physician 2084P0805X
- License
- 12771 (OK)
- Practice address
- 5100 N Brookline Ave
950
Oklahoma City, OK 73112-3623 - Phone
- (405) 717-9840
- Fax
- (405) 942-4790
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Oklahoma College of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Integris Ambulatory Care Corporation
Practice addresses (Care Compare)
5100 N Brookline Ave
900 Integris Mental HLTH Brookline
Oklahoma City, OK 73112-3630
Phone (405) 604-3170
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111215000781 | OK | Practitioner - Psychiatry |
8628088903 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12771 | OK | MD | Geriatric Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integris Ambulatory Care Corporation | Current |
Accepting new patients |
Locations
5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155
5100 N Brookline Ave
Ste 950
Oklahoma City, OK 73112
Phone (405) 717-9840
5100 N Brookline Ave
Ste 900
Oklahoma City, OK 73112
Phone (405) 604-3170
3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589
Interoperability endpoints
- jandrus15054@direct.integrisok.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | 12771 | OK | Yes |
Addresses
Primary practice location
5100 N Brookline Ave
950
Oklahoma City, OK 73112-3623
Mailing address
5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (405) 717-9840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100124020A | Medicaid | OK |
Other providers in Oklahoma City, OK
- Nicole Renee Andrews
- Sharon Kaye Andrews
- Stephanie Andrews
- Joseph Albert Andrezik
- Conner Andrulonis
- Shawn Evan Andrus
- Anesthesia and Tee Services, PC
- Anesthesia Medical Professionals Baptist LLC
- Anesthesia Medical Professionals Edmond LLC
- Anesthesia Medical Professionals NW Okc LLC
All providers in Oklahoma City, OK · Geriatric Psychiatry Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.