NPIMap

Organization Active NPI

Oklahoma State University

Doing business as OSU Physicians Internal Medicine

  • Medical Specialty Clinic/Center
  • Tulsa, OK
National Provider Identifier
1245391200
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
OKLAHOMA STATE UNIVERSITY
Doing business as
OSU Physicians Internal Medicine
Practice address
717 S Houston Ste 300
Tulsa, OK 74127-9006
Phone
(918) 382-5064
Fax
(918) 382-3589
NPI assigned
Dec 13, 2006
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Eric John Polak
Title
VP
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

717 S Houston Ste 300
Tulsa, OK 74127-9006

Mailing address

5310 E 31St St FL 13
Tulsa, OK 74135-5018
Phone (918) 561-5701

Other identifiers 1

IdentifierTypeStateIssuer
100757080AMedicaidOK

Other names 1

  • OSU Physicians Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Community M141 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1245391200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST FL 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279006",
            "telephone_number": "918-382-5064",
            "fax_number": "918-382-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100757080A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU Physicians Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.