Individual provider Active NPI

Jonathan Isenberg, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1255185740
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9114 Issued in OK
Practice address
4502 E 41St St
Tulsa, OK 74135-2536
Phone
(918) 579-2367
NPI assigned
Apr 12, 2024
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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
Emergency Medicine Physician 207P00000X 9114 OK Primary

Addresses

Primary practice location

4502 E 41St St
Tulsa, OK 74135-2536

Mailing address

4502 E 41St St
Tulsa, OK 74135-2536
Phone (918) 579-2367

Other practice location 1

200 2nd Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251125004658 OK Practitioner - Emergency Medicine 5395237408 Reassigns benefits to 2 organizations
I20251218003865 TX Practitioner - Emergency Medicine 5395237408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2024
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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9114OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Sep 15, 2025 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Nov 13, 2025 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Nov 13, 2025 Accepting new patients

Locations

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

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

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: jisenberg883054@ahs.direct-ci.com

Organizations & group practices 5

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": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1255185740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-579-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-579-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 2nd Ave SW",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "OK",
            "postal_code": "743546830",
            "country_code": "US",
            "telephone_number": "918-542-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISENBERG",
        "first_name": "JONATHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-12",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "9114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.