NPIMap

Individual provider Active NPI

Shane Brody Hnatusko, MSIV

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1407215460
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
05-40483 Issued in KS
Practice address
744 W 9TH St
Emergency Medicine Department
Tulsa, OK 74127-9020
Phone
(918) 599-5100
Fax
(918) 599-5065
NPI assigned
Feb 18, 2016
Last updated
May 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 05-40483 KS Primary

Addresses

Primary practice location

744 W 9TH St
Emergency Medicine Department
Tulsa, OK 74127-9020

Mailing address

744 W 9TH St
Emergency Medicine Department
Tulsa, OK 74127-9020
Phone (918) 599-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108001375 OK Practitioner - Emergency Medicine 0446519920 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians

Practice addresses (Care Compare)

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
77.78
Promoting interoperability
99
Improvement activities
40
Cost
73.95

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-40483KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Health System CurrentSince Apr 1, 2020 Accepting new patients
Oklahoma State University Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
McAlester Regional Health Center Authority CurrentSince Mar 24, 2024 Accepting new patients
Oklahoma State University CurrentSince Apr 1, 2024 Accepting new patients
Ies ER Oklahoma LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Northeastern Health System Emergency Medicine Current Accepting new patients
Oklahoma State University Current Accepting new patients
Northeastern Health System CurrentSince Apr 1, 2020 Accepting new patients
Northeastern Health System Emergency Medicine Past Accepting new patients
Saint Francis Hospital South LLC Past Accepting new patients
Oklahoma State University Medical Trust Past Accepting new patients
Northeastern Health System Past Accepting new patients

Locations

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

744 W 9th St
Tulsa, OK 74127
Phone (918) 587-2561

Dept 2563
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/
  • Direct secure messaging: shane.hnatusko.1@23846.direct.athenahealth.com
  • Direct secure messaging: shnatusko325791@ahs.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1407215460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-5100",
            "fax_number": "918-599-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-5100",
            "fax_number": "918-599-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HNATUSKO",
        "first_name": "SHANE",
        "middle_name": "BRODY",
        "name_prefix": "Mr.",
        "credential": "MSIV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-18",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-40483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.