Individual provider Active NPI

Joshua Z Vicena, D.O.

  • Urology Physician
  • Tulsa, OK
National Provider Identifier
1336347392
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
5283 Issued in OK
Practice address
10901 E 48TH St
Tulsa, OK 74146-5830
Phone
(918) 749-8765
Fax
(918) 392-2155
NPI assigned
Jul 10, 2007
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5101018195 MI
Urology Physician 208800000X 5283 OK Primary

Addresses

Primary practice location

10901 E 48TH St
Tulsa, OK 74146-5830

Mailing address

10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MO, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120731000672 OK Practitioner - Urology 4587820816 Reassigns benefits to 2 organizations
I20200420003460 MO Practitioner - Urology 4587820816 Reassigns benefits to 3 organizations
I20210412000341 AR Practitioner - Urology 4587820816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Oklahoma State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
McAlester Medical Services LLCGroup PAC ID 9931139029, 21 clinicians

Practice addresses (Care Compare)

10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765

1605 Martin Springs Dr
Suite 110
Rolla, MO 65401-2982
Phone (573) 458-6300

1965 S Fremont Ave
370 MC Urology S Fremont
Springfield, MO 65804-2284
Phone (417) 820-0300

4 E Clark Bass Blvd
202 Southeast Clinic Urology
McAlester, OK 74501-4285
Phone (918) 421-6090

6801 Rogers Ave
Suite 202
Fort Smith, AR 72903-4067
Phone (918) 749-8765

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018195MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
McAlester Medical Services, LLC Urology CurrentSince Nov 20, 2019 Accepting new patients
Urologic Specialists of Oklahoma Inc Urology CurrentSince Jan 2, 2020 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Feb 16, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 24, 2020 Accepting new patients
Urologic Specialists of Oklahoma Inc Urology CurrentSince Jan 2, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 24, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 24, 2020 Accepting new patients
Ahs Oklahoma Physician Group LLC Urology Past Accepting new patients
McAlester Regional Health Center Authority Past Accepting new patients
Oklahoma Surgical Hospital, LLC Past Accepting new patients

Locations

6801 Rogers Ave
Ste 202
Fort Smith, AR 72903
Phone (479) 573-3947

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 530
Joplin, MO 64804
Phone (417) 556-3828

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 110
Rolla, MO 65401
Phone (573) 458-6300

1965 S Fremont Ave
Ste 370
Springfield, MO 65804
Phone (417) 820-0300

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

4 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6700

4 E Clark Bass Blvd
Ste 202
McAlester, OK 74501
Phone (918) 421-6090

10901 E 48th St
Tulsa, OK 74146
Phone (918) 749-8765

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/37d0fa6b-e0f7-4581-adbb-f9e2eac855e1/
  • Direct secure messaging: joshuavicena@usoinc.medalliesdirect.net
  • Direct secure messaging: jvicena280048@ahs.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oklahoma Surgical Hospital LLCTulsa, OK, CCN 370210 Hospital General Partnership Interest (1.06%) Aug 1, 2021
St John OwassoOwasso, OK, CCN 370227 Hospital Corporate Director (5%) Jan 1, 2024
Bartlett Memorial Medical CenterSapulpa, OK, CCN 371312 Hospital Operational/Managerial Control (10%) Jan 1, 2024
St John Sapulpa IncSapulpa, OK, CCN 37Z312 Hospital Corporate Director (10%) Jan 1, 2024
St John Broken ArrowBroken Arrow, OK, CCN 370235 Hospital Corporate Director (5%) Jan 1, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 7

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1336347392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 E 48TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465830",
            "telephone_number": "918-749-8765",
            "fax_number": "918-392-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 E 48TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465830",
            "telephone_number": "918-749-8765",
            "fax_number": "918-392-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENA",
        "first_name": "JOSHUA",
        "middle_name": "Z",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101018195",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "5283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.