Individual provider Active NPI

Mary Elizabeth Canders, MD

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1235626482
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
38376 Issued in OK
Practice address
1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041
Phone
(918) 579-5749
Fax
(918) 579-5762
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 38376 OK Primary

Addresses

Primary practice location

1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041

Mailing address

1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041
Phone (918) 579-5749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220830003533 CA Practitioner - Family Practice 3779917414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

Hospital & facility affiliations

  • Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38376OKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Sep 1, 2022 Accepting new patients
Providence Facey Medical Foundation Current Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

15451 San Fernando Mission Blvd
Ste 200
Mission Hills, CA 91345
Phone (262) 389-8441

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Interoperability endpoints

  • Direct secure messaging: mcanders2419911@oc.providencedirect.org

Organizations & group practices 4

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1235626482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDERS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "38376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.