Individual provider Active NPI

Amanda Dayle Carey, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1184966335
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5536 Issued in OK
Practice address
2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone
(918) 582-1980
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 5536 OK Primary

Addresses

Primary practice location

2345 Southwest Blvd
Tulsa, OK 74107-2705

Mailing address

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 582-1980

Other identifiers 1

IdentifierTypeStateIssuer
200570680BMedicaidOK

Other names 1

  • Amanda Dayle Alsup Former name

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
I20160706002472 OK Practitioner - Family Practice 9638461924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians

Practice addresses (Care Compare)

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-5701

Hospital & facility affiliations

  • Oklahoma State University Medical Center Hospital, Tulsa, OK, CCN 370078

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
77.78
Promoting interoperability
99
Improvement activities
40
Cost
73.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5536OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University Current Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
State of Oklahoma Past Accepting new patients
Oklahoma State University Medical Trust Past Accepting new patients
Summit Medical Center Past Accepting new patients
Oklahoma State University PastSince Nov 3, 2024 Accepting new patients

Locations

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

Dept 2563
Tulsa, OK 74182

2401 Southwest Blvd
Tulsa, OK 74107

Interoperability endpoints

  • Direct secure messaging: amanda.carey.1@23846.direct.athenahealth.com
  • Direct secure messaging: acarey51221@direct.saintfrancis.com

Organizations & group practices 6

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1184966335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BLVD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072705",
            "telephone_number": "918-582-1980",
            "fax_number": "918-561-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BLVD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072705",
            "telephone_number": "918-582-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "AMANDA",
        "middle_name": "DAYLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200570680B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ALSUP",
            "middle_name": "DAYLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.