Individual provider Active NPI

Maria Isabel Palomo Gamero, MD

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1164917001
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
37300 Issued in OK
Practice address
1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4041
Phone
(918) 579-5749
Fax
(918) 579-5762
NPI assigned
Jun 23, 2018
Last updated
May 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53030284 OH
Student in an Organized Health Care Education/Training Program 390200000X OH
Hospitalist Physician 208M00000X 37300 OK Primary

Addresses

Primary practice location

1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4041

Mailing address

1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4041
Phone (918) 579-5749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220128001430 SC Practitioner - Internal Medicine 2264788793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 782-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53030284OHMDInternal Medicine Physician
37300OKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Jan 15, 2022 Accepting new patients
Trident Medical Center, LLC Past Accepting new patients

Locations

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1164917001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMO GAMERO",
        "first_name": "MARIA ISABEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "53030284",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "37300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.