Individual provider Active NPI

Brian K Berryman, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1184614919
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3710 Issued in OK
Practice address
7912 E 31St CT Ste 200
Tulsa, OK 74145-1334
Phone
(918) 743-8200
Fax
(918) 743-8609
NPI assigned
Oct 24, 2005
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3710 OK Primary

Addresses

Primary practice location

7912 E 31St CT Ste 200
Tulsa, OK 74145-1334

Mailing address

7912 E 31St CT Ste 220
Tulsa, OK 74145-1334
Phone (918) 743-8200

Other practice location 1

1717 S Utica Ave Ste A
Tulsa, OK 74104-5346
Phone (918) 748-1300

Other identifiers 1

IdentifierTypeStateIssuer
200018330AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040301000587 OK Practitioner - Family Practice 1951298470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1145 S Utica Ave
Suite 110
Tulsa, OK 74104-4011

1145 S Utica Ave
Suite 110
Tulsa, OK 74104-4013

7912 E 31St CT
Tulsa, OK 74145-1334

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3710OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Family Physicians P C Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Okmulgee Emergency PLLC Past Accepting new patients

Locations

7912 E 31st Ct
Ste 200
Tulsa, OK 74145
Phone (918) 743-8200

7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457

7912 E 31st Ct
Ste 300
Tulsa, OK 74145
Phone (918) 743-8200

Interoperability endpoints

  • Direct secure messaging: bberryman828851@ahs.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/6925/brand/1/csg/1/fhir/r4

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 3

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1184614919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7912 E 31ST CT STE 220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741451334",
            "telephone_number": "918-743-8200",
            "fax_number": "918-743-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7912 E 31ST CT STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741451334",
            "telephone_number": "918-743-8200",
            "fax_number": "918-743-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S Utica Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045346",
            "country_code": "US",
            "telephone_number": "918-748-1300",
            "fax_number": "918-748-1303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRYMAN",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200018330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.