NPIMap

Organization Active NPI

St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
National Provider Identifier
1154417368
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2265 Issued in OK
Legal business name
ST JOHN MEDICAL CENTER INC
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 744-2345
NPI assigned
Oct 5, 2006
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Ronnie L Hoffman
Title
Chief Operating Officer
Phone
(918) 744-3606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2265 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2345

Other identifiers 3

IdentifierTypeStateIssuer
100699400AMedicaidOK
000370114001OtherOKBCBS OF OK
74104 0000OtherOKCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090723000826 OK Part A Provider - Hospital 7810887510 1 other NPI on this enrollment
Practice locations: Broken Arrow, OK; Tulsa, OK
O20250319000492 OK Part B Supplier - Mass Immunization (Roster Biller Only) 7810887510 Practice locations: Tulsa, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154417368. Details of each certification follow.

Hospital certification: CCN 370114

Legal name
ST JOHN MEDICAL CENTER INC
Doing business as
ASCENSION ST. JOHN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 29, 2024
Beds
703 (675 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1953 in OK
Enrollment address
1923 S Utica Ave
St John Medical Center
Tulsa, OK 74104-6502
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Ascension St John Medical CenterCCN 370114 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Saint Johns Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

800 W Boise Cir
Ste 260
Broken Arrow, OK 74012
Phone (918) 712-1182

1923 S Utica Ave
Unit Snf
Tulsa, OK 74104
Phone (918) 744-2345

8131 S Memorial Dr
Ste 105
Tulsa, OK 74133
Phone (918) 252-1966

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
St John Health Systems Inc Organization, Tulsa, OK Non-profit 5% Or Greater Direct Ownership Interest Sep 8, 1982 100%
Stephen Heyman Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Charles Terrence Dolan Individual Operational/Managerial ControlBoard Member Sep 1, 2015 5%
Joseph P Moran Individual Operational/Managerial ControlBoard Member Sep 1, 2015 5%
Robert Farris Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Jason Hall Individual Corporate OfficerChief Operating Officer Jul 1, 2025 5%
Stephen D Bruns Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Loretta Hall Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Bryan Joseph Cavitt Individual Corporate OfficerPresident Jul 1, 2025 5%
Theodore Siegfried Individual Operational/Managerial ControlBoard Member Jul 1, 2017 5%

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 319

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 319

Affiliated clinicians 927

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 927

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1154417368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "918-744-3606"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699400A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF OK",
            "identifier": "000370114001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "74104 0000",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.