Active NPI
Ann Marie Diana, PA-C
- Surgical Physician Assistant
- Tulsa, OK
National Provider Identifier
1386605376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 1450
- Practice address
- 5801 E 41St St Ste 900
Tulsa, OK 74135-5631 - Phone
- (918) 747-4975
- Fax
- (918) 743-8552
- NPI assigned
- Mar 29, 2006
- Last updated
- Jul 13, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1450 | OK | Primary |
Addresses
Primary practice location
5801 E 41St St Ste 900
Tulsa, OK 74135-5631
Mailing address
PO Box 4930
Tulsa, OK 74159-0930
Phone (918) 747-4975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200058610A | Medicaid | OK |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2748 | AZ | MD | Clinical Social Worker |
| 1450 | OK | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quick Clinic LLC | Past | Accepting new patients | |
| Tulsa Radiology Associates Inc | Past | Accepting new patients | |
| Urology Associates, LTD | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1356412225
-
- Diagnostic Radiology Physician
- Tulsa, OK
- NPI 1871574509
-
- Urology Physician
- Phoenix, AZ
- NPI 1952334690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1386605376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4930",
"city": "TULSA",
"state": "OK",
"postal_code": "741590930",
"telephone_number": "918-747-4975",
"fax_number": "918-743-8552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 E 41ST ST STE 900",
"city": "TULSA",
"state": "OK",
"postal_code": "741355631",
"telephone_number": "918-747-4975",
"fax_number": "918-743-8552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIANA",
"first_name": "ANN",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-29",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OK",
"license": "1450",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200058610A",
"state": "OK"
}
],
"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 Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.