Individual provider Active NPI

Brian W Macha, MD

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1275755654
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
24573 Issued in OK
Practice address
9840 E 81St St Ste 200
Tulsa, OK 74133-4584
Phone
(918) 872-8447
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 24573 OK Primary

Addresses

Primary practice location

9840 E 81St St Ste 200
Tulsa, OK 74133-4584

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 1

IdentifierTypeStateIssuer
200243270AMedicaidOK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090720000341 OK Practitioner - AnesthesiologyPractitioner - Pain Management 3476605684 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sooner Anesthesia Services LLCGroup PAC ID 7416919899, 18 clinicians

Practice addresses (Care Compare)

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 742-2502

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24573OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Health System CurrentSince Sep 7, 2014 Accepting new patients
Anesthesia Associates of Tulsa, PLLC Anesthesiology CurrentSince Mar 18, 2016 Accepting new patients
Northeastern Health System CurrentSince Sep 7, 2014 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

9840 E 81st St
Ste 200
Tulsa, OK 74133
Phone (918) 872-8447

8131 S Memorial Dr
Ste 107
Tulsa, OK 74133
Phone (918) 252-5114

4800 S 109th East Ave
Tulsa, OK 74146
Phone (918) 742-2502

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1275755654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 E 81ST ST STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334584",
            "telephone_number": "918-872-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHA",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "24573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200243270A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.