Individual provider Active NPI

Van An Le, M.D.

  • Diagnostic Radiology Physician
  • Tulsa, OK
National Provider Identifier
1386624435
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
29063 Issued in OK
Practice address
4111 S Darlington Ave
Ste 700
Tulsa, OK 74135-6348
Phone
(918) 747-4975
Fax
(918) 743-9058
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 8783 HI
Diagnostic Radiology Physician 2085R0202X 29063 OK Primary

Addresses

Primary practice location

4111 S Darlington Ave
Ste 700
Tulsa, OK 74135-6348

Mailing address

PO Box 4975
Tulsa, OK 74159-0975
Phone (918) 747-4975

Other identifiers 1

IdentifierTypeStateIssuer
200432110AMedicaidOK

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

State licenses

LicenseStateTypeSpecialty
29063OKMDDiagnostic Radiology Physician
8783HIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Radiology Group Inc. Past Accepting new patients
Tulsa Radiology Associates Inc Diagnostic Radiology PastSince Jul 1, 2009 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1386624435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4975",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741590975",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 S DARLINGTON AVE",
            "address_2": "STE 700",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356348",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "VAN",
        "middle_name": "AN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "HI",
            "license": "8783",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "29063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432110A",
            "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 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.