Individual provider Active NPI

Crysta Chatman, M.D.

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1124382189
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39103 Issued in OK
Practice address
591 E 36TH St N
Tulsa, OK 74106-1812
Phone
(918) 619-4400
Fax
(918) 619-7875
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD043377 DC
Family Medicine Physician 207Q00000X 39103 OK Primary

Addresses

Primary practice location

591 E 36TH St N
Tulsa, OK 74106-1812

Mailing address

1111 S Saint Louis Ave
Tulsa, OK 74120-5440
Phone (918) 619-4400

Other identifiers 1

IdentifierTypeStateIssuer
201100510AMedicaidOK

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
I20221010000671 OK Practitioner - Family Practice 5294043493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

591 E 36TH St N
Ou Physicians Tulsa Wayman Tisdale Clinic
Tulsa, OK 74106-1812
Phone (918) 619-8700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD043377DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Apr 21, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Apr 21, 2025 Accepting new patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Sep 6, 2022 Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

4502 E 41st St
#2G9
Tulsa, OK 74135

591 E 36th St N
Tulsa, OK 74106
Phone (918) 619-8700

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

Interoperability endpoints

  • Direct secure messaging: cchatman28066@ouhealth.direct-ci.net

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1124382189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S SAINT LOUIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205440",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 E 36TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061812",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATMAN",
        "first_name": "CRYSTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD043377",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "39103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201100510A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.