NPIMap

Individual provider Active NPI

Malyke Bray, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1245909878
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5206 Issued in OK
Practice address
1145 S Utica Ave Ste 365
Tulsa, OK 74104-4004
Phone
(918) 728-3354
NPI assigned
Sep 8, 2021
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5206 OK Primary

Addresses

Primary practice location

1145 S Utica Ave Ste 365
Tulsa, OK 74104-4004

Mailing address

8716 E 72ND PL Apt 307
Tulsa, OK 74133-3182
Phone (918) 730-7970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240711003161 TX Practitioner - Physician Assistant 6103361381 Reassigns benefits to 1 organization
I20240717003306 OK Practitioner - Physician Assistant 6103361381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

1313 E 20TH St
Okmulgee Indian Health Center
Okmulgee, OK 74447-6303
Phone (918) 591-5700

500 Eunice Burns Rd
Eufaula, OK 74432-4052
Phone (918) 689-2547

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5206OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 1, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 1, 2024 Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Jul 21, 2025 Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients

Locations

1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

2401 W Main St
Henryetta, OK 74437
Phone (918) 650-1100

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

1145 S Utica Ave
Ste 365
Tulsa, OK 74104
Phone (402) 481-3548

Dept 1467
Tulsa, OK 74182

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1245909878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8716 E 72ND PL APT 307",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741333182",
            "telephone_number": "918-730-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 365",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044004",
            "telephone_number": "918-728-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "MALYKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.