Individual provider Active NPI

Mahima Bhetuwal Panta, FNP-C

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1275358228
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
220893 Issued in OK
Practice address
1919 S Wheeling Ave
Tulsa, OK 74104-5638
Phone
(918) 748-7600
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 220893 OK Primary

Addresses

Primary practice location

1919 S Wheeling Ave
Tulsa, OK 74104-5638

Mailing address

1919 S Wheeling Ave
Tulsa, OK 74104-5638

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
I20241127003577 OK Practitioner - Nurse Practitioner 3971038977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

1919 S Wheeling Ave
Suite 200
Tulsa, OK 74104-5631
Phone (918) 748-7600

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
220893OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prophylaxis Healthcare LLC CurrentSince Nov 19, 2024 Accepting new patients
Prophylaxis Healthcare LLC CurrentSince Nov 19, 2024 Accepting new patients
Omni Medical Group Inc CurrentSince Apr 6, 2026 Accepting new patients
St. John Physicians, Inc. PastSince Apr 6, 2026 Accepting new patients

Locations

1407 SE Washington Blvd
Bartlesville, OK 74006
Phone (918) 335-2273

11911 S Memorial Dr
Bixby, OK 74008
Phone (918) 497-3700

211 S Mill St
Pryor, OK 74361
Phone (918) 825-3777

303 E Taft Ave
Ste 3
Sapulpa, OK 74066
Phone (918) 224-2222

1919 S Wheeling Ave
Ste 200
Tulsa, OK 74104
Phone (918) 748-7600

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 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": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1275358228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTA",
        "first_name": "MAHIMA",
        "middle_name": "BHETUWAL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "220893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.