Individual provider Active NPI

Ravi Kiran Kode, M.D.

  • Cardiovascular Disease Physician
  • Tulsa, OK
National Provider Identifier
1366602617
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
29987 Issued in OK
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 748-7650
Fax
(918) 403-6341
NPI assigned
Jun 11, 2008
Last updated
Mar 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.203831 LA
Cardiovascular Disease Physician 207RC0000X 29987 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 748-7680

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
I20130926000367 OK Practitioner - Cardiovascular Disease (Cardiology) 9638313976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1000 W Boise Circle
Emergency Room
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.203831LAMDInternal Medicine Physician
29987OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Aug 20, 2013 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Aug 20, 2013 Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

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

1919 S Wheeling Ave
Ste 500
Tulsa, OK 74104
Phone (918) 293-6200

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

Organizations & group practices 3

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1366602617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7680",
            "fax_number": "918-403-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7650",
            "fax_number": "918-403-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODE",
        "first_name": "RAVI",
        "middle_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.203831",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "29987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.