Individual provider Active NPI

Reeja John, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1164680575
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26508 Issued in OK
Practice address
4502 E 41St St
Tulsa, OK 74135-9923
Phone
(918) 660-3505
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26508 OK Primary

Addresses

Primary practice location

4502 E 41St St
Tulsa, OK 74135-9923

Mailing address

4502 E 41St St
Tulsa, OK 74135-9923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110913000730 WI Practitioner - Internal Medicine 5294906798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

Hospital & facility affiliations

  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26508OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Oct 14, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1164680575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741359923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741359923",
            "telephone_number": "918-660-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "REEJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "26508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.