Individual provider Active NPI

Ana Gabrielle Trujillo, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1407237530
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0100501 Issued in OK
Practice address
5020 E 68TH St
Tulsa, OK 74136-3307
Phone
(918) 492-3636
Fax
(918) 494-8915
NPI assigned
Jun 15, 2015
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0100501 OK Primary

Addresses

Primary practice location

5020 E 68TH St
Tulsa, OK 74136-3307

Mailing address

5020 E 68TH St
Tulsa, OK 74136-3307
Phone (918) 492-3636

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005001549 OK Practitioner - Nurse Practitioner 4587972963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Oklahoma Ear Nose and Throat IncGroup PAC ID 6507851482, 21 clinicians

Practice addresses (Care Compare)

5020 E 68TH St
Tulsa, OK 74136-3307
Phone (918) 492-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc CurrentSince Aug 5, 2015 Accepting new patients
Eastern Oklahoma Ear, Nose & Throat Inc CurrentSince Sep 21, 2024 Accepting new patients

Locations

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

1923 S Utica Ave
#1000
Tulsa, OK 74104

4720 S Harvard Ave
Ste 100
Tulsa, OK 74135
Phone (918) 749-6730

5020 E 68th St
Tulsa, OK 74136
Phone (918) 491-3314

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1407237530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363307",
            "telephone_number": "918-492-3636",
            "fax_number": "918-494-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363307",
            "telephone_number": "918-492-3636",
            "fax_number": "918-494-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ANA",
        "middle_name": "GABRIELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0100501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.