Individual provider Active NPI

Kavita K Shah, MD

  • Diabetology (Internal Medicine) Physician
  • Tulsa, OK
National Provider Identifier
1174738413
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetology (Internal Medicine) PhysicianTaxonomy code 207QB0505X
License
28092 Issued in OK
Practice address
6126 E 61St St
Tulsa, OK 74136-2117
Phone
(918) 576-6998
Fax
(918) 584-8620
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 28092 OK
Diabetology (Internal Medicine) Physician 207QB0505X 28092 OK Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DR.0071548 CO
Internal Medicine Physician 207R00000X 28092 OK
Internal Medicine Physician 207R00000X 77175 AZ
Internal Medicine Physician 207R00000X P7348 TX

Addresses

Primary practice location

6126 E 61St St
Tulsa, OK 74136-2117

Mailing address

6126 E 61St St
Tulsa, OK 74136-2117
Phone (918) 576-6998

Other practice location 1

12801 E 17th Ave
Mail stop 8106
Aurora, CO 80045
Phone (303) 724-8098

Other identifiers 1

IdentifierTypeStateIssuer
200306790AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110119001353 OK Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - EndocrinologyPractitioner - Emergency Medicine 5092994285 Reassigns benefits to 2 organizations
I20150501001884 TX Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Hospitalist 5092994285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
University of Missouri, Kansas City, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77175AZMDInternal Medicine Physician
DR.0071548COMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Mar 1, 2022 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Sep 1, 2016 Accepting new patients
Tulsa Hospital Medicine Physicians Group, LLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

Interoperability endpoints

  • Direct secure messaging: kshah20843@muscogeecreeknation.direct-ci.com

Organizations & group practices 5

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 4

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1174738413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-576-6998",
            "fax_number": "918-584-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-576-6998",
            "fax_number": "918-584-8620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12801 E 17th Ave",
            "address_2": "Mail stop 8106",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80045",
            "country_code": "US",
            "telephone_number": "303-724-8098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAVITA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "28092",
            "primary": false
        },
        {
            "code": "207QB0505X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Diabetology",
            "state": "OK",
            "license": "28092",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CO",
            "license": "DR.0071548",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "28092",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "77175",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P7348",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200306790A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.