NPIMap

Organization Active NPI

Osu Center for Health Sciences

Doing business as Osu-Aj Osu Medicine Cleveland

  • Clinic/Center
  • Cleveland, OK
National Provider Identifier
1164131967
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OSU CENTER FOR HEALTH SCIENCES
Doing business as
Osu-Aj Osu Medicine Cleveland
Practice address
119 S Broadway St
Cleveland, OK 74020-4614
Phone
(918) 561-8306
Fax
(918) 561-5747
NPI assigned
Nov 21, 2022
Last updated
Nov 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Eric John Polak
Title
Vice President of Admin/Finance
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

119 S Broadway St
Cleveland, OK 74020-4614

Mailing address

1716 S Phoenix Ave
Tulsa, OK 74107-1850
Phone (918) 561-8306

Other names 1

  • OSU-AJ OSU MEDICINE CLEVELAND Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0473158Osu Medicine Cleveland119 South Broadway, Cleveland, OK 74020Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1164131967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 S PHOENIX AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071850",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740204614",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF ADMIN/FINANCE",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU-AJ OSU MEDICINE CLEVELAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.