Organization Active NPI

Sestak Rheumatology

  • Pediatric Rheumatology Physician
  • Oklahoma City, OK
National Provider Identifier
1164140679
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
Legal business name
SESTAK RHEUMATOLOGY
Practice address
3555 NW 58TH St Ste 804
Oklahoma City, OK 73112-4703
Phone
(405) 548-0430
Fax
(405) 463-4408
NPI assigned
Aug 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Andrea L Sestak, MDNPI 1700113289
Title
Manager
Phone
(405) 615-2421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X
Pediatric Rheumatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0216X Primary

Addresses

Primary practice location

3555 NW 58TH St Ste 804
Oklahoma City, OK 73112-4703

Mailing address

3555 NW 58TH St Ste 804
Oklahoma City, OK 73112-4703
Phone (405) 615-2421

National Provider Directory

National Provider Directory

Locations

3555 NW 58th St
Ste 804
Oklahoma City, OK 73112
Phone (405) 548-0430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1164140679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST STE 804",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124703",
            "telephone_number": "405-615-2421",
            "fax_number": "650-727-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST STE 804",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124703",
            "telephone_number": "405-548-0430",
            "fax_number": "405-463-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SESTAK RHEUMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "SESTAK",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-615-2421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.