Active NPI
Ty Douglas Kirkpatrick, D.O.
- Surgery Physician
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5243
- Practice address
- 1725 E 19TH St Ste 800
Tulsa, OK 74104-5464 - Phone
- (918) 301-2505
- Fax
- (918) 744-3633
- NPI assigned
- Apr 27, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5243 | OK | Primary |
Addresses
Primary practice location
1725 E 19TH St Ste 800
Tulsa, OK 74104-5464
Mailing address
1725 E 19TH St Ste 800
Tulsa, OK 74104-5464
Phone (918) 301-2505
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Oklahoma State University College of Osteopathic Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1705 E 19TH St
Tulsa, OK 74104-5410
1919 S Wheeling Ave
Tulsa, OK 74104-5634
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 22 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5243 | OK | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. John Physicians, Inc. | Current | Accepting new patients | |
| St. John Physicians, Inc | Current | Accepting new patients | |
| St John Medical Center Inc | Past | Accepting new patients |
Locations
12455 E 100th St N
Owasso, OK 74055
Phone (918) 392-1513
1725 E 19th St
Ste 800
Tulsa, OK 74104
Phone (918) 301-2505
1919 S Wheeling Ave
Ste 504
Tulsa, OK 74104
Phone (918) 747-8071
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200
Interoperability endpoints
- ty.kirkpatrick@direct.stjohnhealthsystem.com
- tkirkpatrick714765@directa.mercy.net
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1336194406
-
- Rural Health Clinic/Center
- Barnsdall, OK
- NPI 1033176367
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1154417368
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1154417368
-
- Rehabilitation Hospital Unit
- Tulsa, OK
- NPI 1578656161
-
- General Acute Care Hospital
- Broken Arrow, OK
- NPI 1497988596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1235420043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 E 19TH ST STE 800",
"city": "TULSA",
"state": "OK",
"postal_code": "741045464",
"telephone_number": "918-301-2505",
"fax_number": "918-744-3633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 E 19TH ST STE 800",
"city": "TULSA",
"state": "OK",
"postal_code": "741045464",
"telephone_number": "918-301-2505",
"fax_number": "918-744-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKPATRICK",
"first_name": "TY",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-27",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "5243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.