Individual provider Active NPI

Jessica Marie Koshy, DO

  • Obstetrics & Gynecology Physician
  • Tulsa, OK
National Provider Identifier
1376006494
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
7044 Issued in OK
Practice address
8803 S 101St East Ave Ste 245
Tulsa, OK 74133-5730
Phone
(918) 858-0008
NPI assigned
Apr 8, 2019
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 7044 OK Primary

Addresses

Primary practice location

8803 S 101St East Ave Ste 245
Tulsa, OK 74133-5730

Mailing address

8803 S 101St East Ave Ste 245
Tulsa, OK 74133-5730
Phone (580) 799-3868

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
I20230823000516 OK Practitioner - Obstetrics/Gynecology 6800259946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oklahoma State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-5701

8803 S 101St E Ave
Suite 245
Tulsa, OK 74133-5730
Phone (918) 392-0175

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC CurrentSince Sep 1, 2023 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Ahs Southcrest Hospital, LLC Past Accepting new patients

Locations

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

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

8803 S 101st East Ave
Ste 205
Tulsa, OK 74133
Phone (918) 749-0898

8803 S 101st East Ave
Ste 245
Tulsa, OK 74133
Phone (918) 392-7077

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: jsorelle290364@ahs.direct-ci.com

Organizations & group practices 5

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 3

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1376006494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 S 101ST EAST AVE STE 245",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335730",
            "telephone_number": "580-799-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 S 101ST EAST AVE STE 245",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335730",
            "telephone_number": "918-858-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "7044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.