Individual provider Active NPI

Brooklyn Diane McColey-Tuttle, DPT, PT

  • Physical Therapist
  • Broken Arrow, OK
National Provider Identifier
1316760838
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6490 Issued in OK
Practice address
3341 S Elm PL
Broken Arrow, OK 74012-7924
Phone
(918) 449-1332
Fax
(918) 449-8732
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6490 OK Primary

Addresses

Primary practice location

3341 S Elm PL
Broken Arrow, OK 74012-7924

Mailing address

3341 S Elm PL
Broken Arrow, OK 74012-7924
Phone (918) 449-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260330000981 OK Practitioner - Physical Therapist in Private Practice 8921583840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Oklahoma College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics of Oklahoma PLLCGroup PAC ID 8426320912, 90 clinicians

Practice addresses (Care Compare)

2488 E 81St St
Suite 290
Tulsa, OK 74137-4265
Phone (918) 494-2665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6490OKMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arrow Physical Therapy Limited Partnership Physical Therapist PastSince Nov 10, 2024 Accepting new patients
Arrow Physical Therapy Limited Partnership PastSince Nov 10, 2024 Accepting new patients

Organizations & group practices 3

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1316760838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127924",
            "telephone_number": "918-449-1332",
            "fax_number": "918-449-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3341 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127924",
            "telephone_number": "918-449-1332",
            "fax_number": "918-449-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLEY-TUTTLE",
        "first_name": "BROOKLYN",
        "middle_name": "DIANE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.