Individual provider Active NPI

Scott A Kreitzberg, D.O.

  • Plastic and Reconstructive Surgery Physician
  • Tulsa, OK
National Provider Identifier
1225397797
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
6831 Issued in OK
Practice address
8010 S 101St East Ave Ste 100
Tulsa, OK 74133-4562
Phone
(918) 940-4700
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5315085034 MI
Surgery Physician 208600000X 5101019676 MI
Plastic and Reconstructive Surgery Physician 2086S0122X 6831 OK Primary

Addresses

Primary practice location

8010 S 101St East Ave Ste 100
Tulsa, OK 74133-4562

Mailing address

8010 S 101St East Ave Ste 100
Tulsa, OK 74133-4562
Phone (918) 940-4700

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
I20200821000974 OK Practitioner - Plastic and Reconstructive Surgery 1456671411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315085034MIMDSurgery Physician
6831OKMDPlastic and Reconstructive Surgery Physician

Interoperability endpoints

  • Direct secure messaging: skreitzberg294531@ahs.direct-ci.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1225397797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 S 101ST EAST AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334562",
            "telephone_number": "918-940-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 S 101ST EAST AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334562",
            "telephone_number": "918-940-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZBERG",
        "first_name": "SCOTT",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5315085034",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101019676",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OK",
            "license": "6831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.