Individual provider Active NPI

Michael Tylka, DNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1215719067
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
215486 Issued in OK
Practice address
3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone
(405) 949-3011
NPI assigned
Oct 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 215486 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Oklahoma City, OK 73112-4418

Mailing address

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729001124 OK Practitioner - Nurse Practitioner 3577009398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
215486OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jun 17, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Jun 17, 2024 Accepting new patients

Locations

825 NE 10th St
#2E
Oklahoma City, OK 73104
Phone (405) 271-7001

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1215719067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLKA",
        "first_name": "MICHAEL",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "215486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.