Andrew Bowman, PA
Individual provider Active NPI Physician Assistant · Tulsa, OK
NPI 1124769203 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1124769203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1120 S Utica Ave
Tulsa, OK 74104-4012 - Phone
- (918) 592-0999
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ahs Oklahoma Heart LLC
Healthtexas Provider Network
Practice addresses (Care Compare)
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 592-0999
821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200
9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999
Hospital & facility affiliations
- Baylor Scott & White the Heart Hospital Plano
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122001789 | OK | Practitioner - Physician Assistant | 7911375951 | Reassigns benefits to 1 organization |
| I20231120000343 | TX | Practitioner - Physician Assistant | 7911375951 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4852 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Integris Cardiovascular Physicians LLC | Past | Accepting new patients | |
| Oklahoma Heart Inc | Past | Accepting new patients |
Locations
4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665
301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330
821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200
Interoperability endpoints
- abowman560742@ahs.direct-ci.com
- https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4
- abowman1239411@direct.sw.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1120 S Utica Ave
Tulsa, OK 74104-4012
Mailing address
150 Enclave Cir Apt B6
Cape Girardeau, MO 63701-2880
Phone (901) 849-7047
Other practice location 1
1265 S Utica Ave
Tulsa, OK 74104-4243
Phone (918) 592-0999
Other providers in Tulsa, OK
- Jeremy Michael Bowles
- Aaron Christopher Bowlin
- Jessica Maria Bowlin
- Brett Bowline
- April Shea Bowling
- Hartley Nicole Bowman
- Jaci Shey Bowman
- Jayne Alberta Bowman
- Thomas Dean Bowman
- Windy Ann Bowman
All providers in Tulsa, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. 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.