Individual provider Active NPI

Angela M Wrobleski, PA-C

  • Surgical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1154373371
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2010042898 Issued in MO
Practice address
6151 S Yale Ave
Suite 1305
Tulsa, OK 74136-1907
Phone
(918) 494-9450
Fax
(918) 494-9437
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1400 OK
Surgical Physician Assistant 363AS0400X 2010042898 MO Primary

Addresses

Primary practice location

6151 S Yale Ave
Suite 1305
Tulsa, OK 74136-1907

Mailing address

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347
Phone (918) 488-6001

Other identifiers 1

IdentifierTypeStateIssuer
200045670AMedicaidOK

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060823000519 OK Practitioner - Physician Assistant 7517960016 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1400OKMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Oct 1, 2014 Accepting new patients
Pediatric Surgery, Inc. Past Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6151 S Yale Ave
Ste 305
Tulsa, OK 74136
Phone (918) 494-9494

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6151 S Yale Ave
Ste 1305
Tulsa, OK 74136
Phone (918) 494-9450

Interoperability endpoints

  • Direct secure messaging: awrobleski83116@direct.saintfrancis.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1154373371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "address_2": "SUITE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347",
            "telephone_number": "918-488-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151 S YALE AVE",
            "address_2": "SUITE 1305",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361907",
            "telephone_number": "918-494-9450",
            "fax_number": "918-494-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROBLESKI",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1400",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2010042898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.