Individual provider Active NPI

Rahul Haridas Rahangdale, M.D.

  • Vascular Neurology Physician
  • Tulsa, OK
National Provider Identifier
1295118065
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
35564 Issued in OK
Practice address
2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647
Phone
(918) 748-7810
Fax
(918) 403-6437
NPI assigned
Jun 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 35564 OK Primary

Addresses

Primary practice location

2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647

Mailing address

2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647
Phone (918) 748-7810

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
I20200729001018 OK Practitioner - Neurology 7618265265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1000 W Boise Circle
Emergency Room
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 27, 2020 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

2000 S Wheeling Ave
Ste 701
Tulsa, OK 74104
Phone (918) 744-7887

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

Organizations & group practices 2

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 6

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1295118065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 701",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045647",
            "telephone_number": "918-748-7810",
            "fax_number": "918-403-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 701",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045647",
            "telephone_number": "918-748-7810",
            "fax_number": "918-403-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHANGDALE",
        "first_name": "RAHUL",
        "middle_name": "HARIDAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OK",
            "license": "35564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.