NPIMap

Individual provider Active NPI

Tanya L. Livingston, M.D.

  • Family Medicine Physician
  • Yukon, OK
National Provider Identifier
1316986854
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21699 Issued in OK
Practice address
1205 Health Center Pkwy
Suite 100
Yukon, OK 73099-6396
Phone
(405) 717-5400
Fax
(405) 717-5467
NPI assigned
Jun 6, 2006
Last updated
Jul 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21699 OK Primary

Addresses

Primary practice location

1205 Health Center Pkwy
Suite 100
Yukon, OK 73099-6396

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 717-5400

Other identifiers 1

IdentifierTypeStateIssuer
100108460AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000948 OK Practitioner - Family Practice 1254398613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

1205 Health Ctr Pkwy
Suite 100
Yukon, OK 73099-6396
Phone (405) 717-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21699OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jan 1, 2005 Accepting new patients
Summit Medical Center Past Accepting new patients
Lightstar Emergency Physicians, PLLC Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients

Locations

600 S Monroe St
Enid, OK 73701
Phone (580) 233-2300

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

100 Valley Dr
Pauls Valley, OK 73075
Phone (405) 238-5501

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

1205 Health Center Pkwy
Ste 100
Yukon, OK 73099
Phone (405) 350-1882

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Interoperability endpoints

  • Direct secure messaging: tlivingston4791@direct.integrisok.com

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1316986854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-717-5400",
            "fax_number": "405-717-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 HEALTH CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996396",
            "telephone_number": "405-717-5400",
            "fax_number": "405-717-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "TANYA",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108460A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.