Individual provider Active NPI

Paul-Andrew Cromer

  • Adult Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1346623980
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
103011 Issued in OK
Practice address
10901 E 48TH St
Tulsa, OK 74146-5830
Phone
(918) 749-8765
Fax
(918) 392-2155
NPI assigned
Jul 1, 2015
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
Adult Health Nurse Practitioner 363LA2200X 103011 OK Primary
Gerontology Nurse Practitioner 363LG0600X 103011 OK

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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014002453 OK Practitioner - Nurse Practitioner 9032428099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urologic Specialists of Oklahoma Inc 45 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Oklahoma Surgical Hospital, LLC Hospital, Tulsa, OK, CCN 370210
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
103011OKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urologic Specialists of Oklahoma Inc CurrentSince Sep 1, 2018 Accepting new patients
Omni Medical Group Inc CurrentSince Jul 7, 2015 Accepting new patients
Urologic Specialists of Oklahoma Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

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

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

8115 S Memorial Dr
Tulsa, OK 74133
Phone (918) 254-6315

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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1346623980",
    "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": "CROMER",
        "first_name": "PAUL-ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "103011",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "103011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.