Individual provider Active NPI

Shivrajpal Grewal, M.D.

  • Internal Medicine Physician
  • Sand Springs, OK
National Provider Identifier
1396713483
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13202 Issued in OK
Practice address
402 W Morrow Rd
100
Sand Springs, OK 74063-6549
Phone
(918) 245-2309
Fax
(918) 293-3181
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13202 OK Primary

Addresses

Primary practice location

402 W Morrow Rd
100
Sand Springs, OK 74063-6549

Mailing address

402 W Morrow Rd
100
Sand Springs, OK 74063-6549
Phone (918) 245-2309

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
I20100914001281 OK Practitioner - Internal Medicine 6507775798 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13202OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc Internal Medicine CurrentSince Sep 1, 1997 Accepting new patients
St. John Physicians, Inc CurrentSince Apr 5, 2013 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Apr 5, 2013 Accepting new patients

Locations

402 W Morrow Rd
Ste 100
Sand Springs, OK 74063
Phone (918) 245-1328

402 W Morrow Rd
#100
Sand Springs, OK 74063
Phone (918) 245-1328

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

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

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1396713483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W MORROW RD",
            "address_2": "100",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636549",
            "telephone_number": "918-245-2309",
            "fax_number": "918-293-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W MORROW RD",
            "address_2": "100",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636549",
            "telephone_number": "918-245-2309",
            "fax_number": "918-293-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "SHIVRAJPAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "13202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sand Springs, OK

Sources for this page

Verify at the official NPI Registry.