NPIMap

Organization Active NPI

Parkside, Inc.

  • Adult Mental Health Clinic/Center
  • Tulsa, OK
National Provider Identifier
1356552111
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
2261 Issued in OK
Legal business name
PARKSIDE, INC.
Practice address
1239 S Trenton Ave
Tulsa, OK 74120-5420
Phone
(918) 582-2131
Fax
(918) 588-8822
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Mr. William Eric Sachau
Title
Exec. Director Admin SVCS.
Phone
(918) 582-2131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 2261 OK Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 2261 OK

Addresses

Primary practice location

1239 S Trenton Ave
Tulsa, OK 74120-5420

Mailing address

1239 S Trenton Ave
Tulsa, OK 74120-5420
Phone (918) 582-2131

Other practice location 1

1220 S Trenton Ave
Tulsa, OK 74120-5421
Phone (918) 588-8888

Other identifiers 1

IdentifierTypeStateIssuer
100738360DMedicaidOK

Other names 1

  • Parkside Professional Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000336 OK Part B Supplier - Clinic/Group Practice 5496644049 Receives reassigned benefits from 23 practitioners
4 other NPIs on this enrollment
Practice locations: Tulsa, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Parkside Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Parkside Psychiatric Hospital & ClinicTulsa, OK, CCN 374021 Hospital Operational/Managerial Control Dec 27, 1991

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1356552111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 S TRENTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205420",
            "telephone_number": "918-582-2131",
            "fax_number": "918-588-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 S TRENTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205420",
            "telephone_number": "918-582-2131",
            "fax_number": "918-588-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 S Trenton Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741205421",
            "country_code": "US",
            "telephone_number": "918-588-8888",
            "fax_number": "918-588-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARKSIDE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "SACHAU",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "EXEC. DIRECTOR ADMIN SVCS.",
        "authorized_official_telephone_number": "918-582-2131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OK",
            "license": "2261",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OK",
            "license": "2261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100738360D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Professional",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.