Active NPI
Donald R Seidel, MD
- Dermatology Physician
- Tulsa, OK
National Provider Identifier
1316933286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 18365
- Practice address
- 2121 E 21St St
Tulsa, OK 74114-1409 - Phone
- (918) 749-2261
- Fax
- (918) 749-8712
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 18365 | OK | Primary |
Addresses
Primary practice location
2121 E 21St St
Tulsa, OK 74114-1409
Mailing address
PO Box 52588
Tulsa, OK 74152-0588
Phone (918) 749-2261
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070005811 | Other | RAILROAD MEDICARE | |
| 18365 | Other | OK | STATE MEDICAL LICENSE NUM |
| 100190040A | Medicaid | OK | |
| 4315191 | Other | AETNA PPO | |
| 876750 | Other | AETNA HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18365 | OK | MD | Dermatology Physician |
Interoperability endpoints
- donald.seidel@direct.stjohnhealthsystem.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1316933286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52588",
"city": "TULSA",
"state": "OK",
"postal_code": "741520588",
"telephone_number": "918-749-2261",
"fax_number": "918-749-8712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 E 21ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741141409",
"telephone_number": "918-749-2261",
"fax_number": "918-749-8712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDEL",
"first_name": "DONALD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OK",
"license": "18365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070005811",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE NUM",
"identifier": "18365",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100190040A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4315191",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "876750",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.