Individual provider Active NPI

Bradley D Edgington, DO

  • Pulmonary Disease Physician
  • Tulsa, OK
National Provider Identifier
1366588295
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
52202 Issued in MN
Practice address
1725 E 19TH St Ste 200
Tulsa, OK 74104
Phone
(918) 748-8381
Fax
(918) 403-6328
NPI assigned
Jan 29, 2007
Last updated
Nov 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4292 OK
Internal Medicine Physician 207R00000X 104566 MN
Internal Medicine Physician 207R00000X 52202 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 52202 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4292 OK
Pulmonary Disease Physician 207RP1001X 52202 MN Primary
Pulmonary Disease Physician 207RP1001X 4292 OK

Addresses

Primary practice location

1725 E 19TH St Ste 200
Tulsa, OK 74104

Mailing address

1725 E 19TH St Ste 200
Tulsa, OK 74104
Phone (918) 748-8381

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129001755 OK Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2466586599 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians
Ahs Claremore Regional Hospital LLCGroup PAC ID 4284809278, shared by 3 NPIs, 31 clinicians
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Suite 220
Owasso, OK 74055-6638
Phone (918) 376-8830

1501 N Florence Ave
Claremore, OK 74017-3179
Phone (918) 579-3627

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4292OKMDPhysical Therapist
104566MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jan 13, 2015 Accepting new patients
Warren Clinic Inc CurrentSince Sep 25, 2023 Accepting new patients
Ahs Oklahoma Physician Group LLC Internal Medicine CurrentSince Jan 30, 2026 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Jan 13, 2015 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jan 30, 2026 Accepting new patients
Tulsa Pulmonary and Allergy Consultants Inc Critical Care Medicine Past Accepting new patients

Locations

1501 N Florence Ave
Ste 201
Claremore, OK 74017
Phone (918) 341-1886

10512 N 110th East Ave
Ste 220
Owasso, OK 74055
Phone (918) 516-1919

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: bedgington299687@direct.saintfrancis.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 6

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

Hospital & facility affiliations 6

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1366588295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-8381",
            "fax_number": "918-403-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-8381",
            "fax_number": "918-403-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGINGTON",
        "first_name": "BRADLEY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "4292",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "104566",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "52202",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "52202",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OK",
            "license": "4292",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "52202",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OK",
            "license": "4292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.