Individual provider Active NPI

Luka Brittany Cavalli, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1255040846
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4866 Issued in OK
Practice address
1265 S Utica Ave Ste 300
Tulsa, OK 74104-4243
Phone
(918) 592-0999
Fax
(918) 592-1021
NPI assigned
Nov 22, 2022
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 4866 OK Primary

Addresses

Primary practice location

1265 S Utica Ave Ste 300
Tulsa, OK 74104-4243

Mailing address

4327 S Allegheny Ave
Tulsa, OK 74135-6313
Phone (405) 795-4418

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000897 OK Practitioner - Physician Assistant 7315318631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 592-0999

1265 S Utica Ave
Tulsa, OK 74104-4243

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4866OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Physician Assistant PastSince Sep 1, 2004 Accepting new patients
Ahs Oklahoma Physician Group, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: ljoyner559257@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1255040846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 S ALLEGHENY AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356313",
            "telephone_number": "405-795-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S UTICA AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLI",
        "first_name": "LUKA",
        "middle_name": "BRITTANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.