Active NPI
Tyler Gregory Ellington, DO
- Cardiovascular Disease Physician
- Owasso, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 6866
- Practice address
- 10512 N 110TH East Ave
Owasso, OK 74055-6636 - Phone
- (918) 592-0999
- NPI assigned
- Apr 18, 2014
- Last updated
- Aug 1, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10049312 | TX | |
| Cardiovascular Disease Physician | 207RC0000X | 6866 | OK | Primary |
Addresses
Primary practice location
10512 N 110TH East Ave
Owasso, OK 74055-6636
Mailing address
9228 S Mingo Rd Ste 200
Tulsa, OK 74133-5722
Phone (918) 592-0999
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Oklahoma State University College of Osteopathic Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10512 N 110TH E Ave
Suite 100
Owasso, OK 74055-6638
Phone (918) 376-8400
1501 N Florence Ave
Suite 101 201 250 and 300
Claremore, OK 74017-3179
Phone (918) 579-3627
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6866 | OK | MD | Physical Therapist |
| BP10049312 | TX | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Claremore Regional Hospital, LLC | Current | Accepting new patients | |
| Ahs Claremore Regional Hospital LLC | Current | Accepting new patients | |
| Ahs Oklahoma Heart LLC | Current | Accepting new patients |
Locations
201 W Blue Starr Dr
Claremore, OK 74017
Phone (918) 341-1311
10512 N 110th East Ave
Ste 100
Owasso, OK 74055
Phone (918) 272-6333
1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 579-2981
9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820
Dept 1218
Tulsa, OK 74182
Interoperability endpoints
- tellington290471@ahs.direct-ci.com
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.
-
- Rural Health Clinic/Center
- Claremore, OK
- NPI 1316579642
-
- Rural Health Clinic/Center
- Claremore, OK
- NPI 1356974687
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hillcrest Hospital Claremore
- General Acute Care Hospital
- Claremore, OK
- NPI 1023398807
-
dba Hillcrest Medical Center
- General Acute Care Hospital
- Tulsa, OK
- NPI 1629057229
-
dba Hillcrest Hospital Pryor
- General Acute Care Hospital
- Pryor, OK
- NPI 1780125005
-
dba HIllcrest Hospital South
- General Acute Care Hospital
- Tulsa, OK
- NPI 1750661534
-
- General Acute Care Hospital
- Owasso, OK
- NPI 1205846037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596240000000",
"number": "1326468224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9228 S MINGO RD STE 200",
"city": "TULSA",
"state": "OK",
"postal_code": "741335722",
"telephone_number": "918-592-0999",
"fax_number": "918-592-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10512 N 110TH EAST AVE",
"city": "OWASSO",
"state": "OK",
"postal_code": "740556636",
"telephone_number": "918-592-0999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGTON",
"first_name": "TYLER",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-18",
"last_updated": "2020-08-01",
"certification_date": "2020-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "BP10049312",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OK",
"license": "6866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.