Active NPI
Joe Tre Landrum, DO
- Otolaryngology/Facial Plastic Surgery Physician
- Ada, OK
National Provider Identifier
1366480998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- License
- 4310
- Practice address
- 730 Finley Dr
Ada, OK 74820-5392 - Phone
- (580) 421-6470
- NPI assigned
- Jun 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | 4310 | OK | Primary |
Addresses
Primary practice location
730 Finley Dr
Ada, OK 74820-5392
Mailing address
730 Finley Dr
Ada, OK 74820-5392
Phone (580) 421-6470
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051229000175 | OK | Practitioner - Otolaryngology | 4880614734 |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Oklahoma State University College of Osteopathic Medicine, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
730 Finley Dr
Ada, OK 74820-5392
Hospital & facility affiliations
- Mercy Hospital Ada
- Chickasaw Nation Medical Center
- McAlester Regional Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4310 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boogers R US PLLC | Otolaryngology | Current | Accepting new patients |
| Mayes County Hma, LLC | Past | Accepting new patients | |
| Mercy Hospital Ada, Inc | Past | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
730 Finley Dr
Ada, OK 74820
Phone (580) 421-6470
520 N Monte Vista St
Ste B
Ada, OK 74820
Phone (580) 421-5756
415 W Guy Ave
Ofc
Pauls Valley, OK 73075
Phone (580) 421-6470
Interoperability endpoints
- jlandrum@landrument.mdlogic.direct-ci.com
Organizations & group practices 4
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.
-
- Otolaryngology Physician
- Ada, OK
- NPI 1871864439
-
- General Acute Care Hospital
- Pryor, OK
- NPI 1588686679
-
- General Acute Care Hospital
- Ada, OK
- NPI 1952643306
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ada, OK
- NPI 1255364923
-
- Primary Care Clinic/Center
- Tishomingo, OK
- NPI 1649330242
Hospital
-
- Primary Care Clinic/Center
- Ada, OK
- NPI 1962563148
Hospital
-
- Rural Acute Care Hospital
- McAlester, OK
- NPI 1316940034
-
- General Acute Care Hospital
- Ada, OK
- NPI 1952643306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758412800000",
"number": "1366480998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 FINLEY DR",
"city": "ADA",
"state": "OK",
"postal_code": "748205392",
"telephone_number": "580-421-6470",
"fax_number": "580-421-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 FINLEY DR",
"city": "ADA",
"state": "OK",
"postal_code": "748205392",
"telephone_number": "580-421-6470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRUM",
"first_name": "JOE",
"middle_name": "TRE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-04",
"last_updated": "2025-09-21",
"certification_date": "2025-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "OK",
"license": "4310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.