Organization Active NPI

Jeffrey M. Calava D.O., Inc

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1346311776
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3179 Issued in OK
Legal business name
JEFFREY M. CALAVA D.O., INC
Practice address
6802 S Olympia Ave
Ste 250
Tulsa, OK 74132-1827
Phone
(918) 481-6494
Fax
(918) 481-6726
NPI assigned
Nov 9, 2006
Last updated
Nov 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Dr. Jeffrey M Calava, D.O.NPI 1194791608
Title
Ceo
Phone
(918) 481-6494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 3179 OK
Anesthesiology Physician 207L00000X 3179 OK Primary

Addresses

Primary practice location

6802 S Olympia Ave
Ste 250
Tulsa, OK 74132-1827

Mailing address

6802 S Olympia Ave
Ste 250
Tulsa, OK 74132-1827
Phone (918) 481-6494

Other identifiers 6

IdentifierTypeStateIssuer
200260790AMedicaidOK
100176380AMedicaidOK
483768838002OtherOKBCBS
050056583OtherOKRAILROAD MEDICARE
800522531OtherOKMEDICARE ID
DG6124OtherOKRAILROAD MEDICARE

Other names 1

  • Specialty Pain Management Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061003000109 OK Part B Supplier - Clinic/Group Practice 8022013721 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2009787Specialty Pain Management Center6802 South Olympia Avenue, Ste 250, Tulsa, OK 74132Certificate of waiverJul 13, 2028

National Provider Directory

National Provider Directory

Locations

6802 S Olympia Ave
Ste 250
Tulsa, OK 74132
Phone (918) 481-6494

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1346311776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE 250",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321827",
            "telephone_number": "918-481-6494",
            "fax_number": "918-481-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE 250",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321827",
            "telephone_number": "918-481-6494",
            "fax_number": "918-481-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M. CALAVA D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "CALAVA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-481-6494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "3179",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "3179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200260790A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100176380A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "483768838002",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050056583",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "800522531",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG6124",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Pain Management Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 10, 2009; 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.