Individual provider Active NPI

Addison Elaine McGinn, MD

  • Cardiovascular Disease Physician
  • Tulsa, OK
National Provider Identifier
1124589775
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34772 Issued in OK
Practice address
1923 S Utica Ave FL 4
Tulsa, OK 74104-6520
Phone
(918) 748-7650
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34772 OK Primary

Addresses

Primary practice location

1923 S Utica Ave FL 4
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave FL 4
Tulsa, OK 74104-6520

Other names 1

  • Addison Elaine Jezek Former name

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
I20250806003052 OK Practitioner - Cardiovascular Disease (Cardiology) 6305224494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Oklahoma College of Medicine, 2019
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)

1000 W Boise Circle
Emergency Room
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

1705 E 19TH St
Tulsa, OK 74104-5410

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34772OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Aug 25, 2025 Accepting new patients
St. John Physicians, Inc. Cardiovascular Disease CurrentSince Jun 15, 2025 Accepting new patients

Locations

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

1923 S Utica Ave
Fl 4
Tulsa, OK 74104
Phone (918) 748-7650

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

Interoperability endpoints

  • Direct secure messaging: amcginn1064357@direct.sw.org

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.

Hospital & facility affiliations 8

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1124589775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE FL 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE FL 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINN",
        "first_name": "ADDISON",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "34772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADDISON",
            "last_name": "JEZEK",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.