Active NPI
Paul Anthony Bevilacqua, M.D.
- Anesthesiology Physician
- Tulsa, OK
National Provider Identifier
1376505461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 17304
- Practice address
- 1802 E 19TH St
400
Tulsa, OK 74104-5425 - Phone
- (918) 748-7644
- Fax
- (918) 293-3184
- NPI assigned
- Apr 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 17304 | OK | Primary |
Addresses
Primary practice location
1802 E 19TH St
400
Tulsa, OK 74104-5425
Mailing address
1611 S Utica Ave
PMB 217
Tulsa, OK 74104-4909
Phone (918) 744-2618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. John Anesthesia Services, Inc. | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Tulsa, OK
- NPI 1265446579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1376505461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 S UTICA AVE",
"address_2": "PMB 217",
"city": "TULSA",
"state": "OK",
"postal_code": "741044909",
"telephone_number": "918-744-2618",
"fax_number": "918-293-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 E 19TH ST",
"address_2": "400",
"city": "TULSA",
"state": "OK",
"postal_code": "741045425",
"telephone_number": "918-748-7644",
"fax_number": "918-293-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVILACQUA",
"first_name": "PAUL",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "17304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.