Individual provider Active NPI

Phillip William Easterly, PT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1346892585
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5729 Issued in OK
Practice address
9100 E 46TH St N
Tulsa, OK 74115-1000
Phone
(580) 541-6093
NPI assigned
Jul 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5729 OK Primary

Addresses

Primary practice location

9100 E 46TH St N
Tulsa, OK 74115-1000

Mailing address

3915 W 15TH Ave
Stillwater, OK 74074-1672

Other practice location 1

2488 E 81st St Ste 290
Tulsa, OK 74137-4265
Phone (918) 927-3199

Other identifiers 1

IdentifierTypeStateIssuer
1346892585OtherOKNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210000467 OK Practitioner - Physical Therapist in Private Practice 0648603449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics of Oklahoma PLLCGroup PAC ID 8426320912, 90 clinicians

Practice addresses (Care Compare)

2488 E 81St St
Suite 290
Tulsa, OK 74137-4265
Phone (918) 494-2665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics of Oklahoma PLLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Advanced Orthopedics of Oklahoma PLLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients

Locations

1071 W Blue Starr Dr
Ste 105
Claremore, OK 74017
Phone (918) 283-2992

205 E B St
Jenks, OK 74037
Phone (918) 299-4411

2488 E 81st St
Ste 290
Tulsa, OK 74137
Phone (918) 494-2665

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGJHAD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1346892585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 W 15TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740741672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 E 46TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741151000",
            "telephone_number": "580-541-6093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2488 E 81st St Ste 290",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741374265",
            "country_code": "US",
            "telephone_number": "918-927-3199",
            "fax_number": "918-927-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASTERLY",
        "first_name": "PHILLIP",
        "middle_name": "WILLIAM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-09",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346892585",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2022; 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.