Michael Wackowski, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

18451 Issued in OK

Practice address

6161 S Yale Ave
Tulsa, OK 74136-1902

Phone

(918) 502-1900

Fax

(918) 494-6303

NPI assigned

Mar 20, 2006

Last updated

Dec 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

HospitalistAlso: Internal Medicine

Education

University of Missouri, Columbia School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
• Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwackowski7763@direct.saintfrancis.com

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.

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment Care Compare group NPD
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  NPD (past)
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Hospital Muskogee Inc

  dba Saint Francis Hospital Muskogee

  • General Acute Care Hospital
  • Muskogee, OK
  • NPI 1386188837
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1275592354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347",
            "telephone_number": "918-488-6687",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-502-1900",
            "fax_number": "918-494-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 S Wheeling Ave",
            "address_2": "200",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045638",
            "country_code": "US",
            "telephone_number": "918-748-7600",
            "fax_number": "918-293-3109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACKOWSKI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18451",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "18451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100020120A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Hoang Vuong
• W Richard Loerke
• W. Scott Harrington DMD Inc.
• Wa Billco LLC
• Amy Lee Wachtman, CO
• Rebecca M Wackowski, M.D.
• Jourdan Waddell, MPH
• Wade Sessom, DDS, PC
• Jacqueline Sherry Wade, BMHCC, IINHCC, BHCC,
• Kimberly Wade, M.S., CCC-SLP

• Hospitalist Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Hospitalist Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.