NPIMap

Individual provider Active NPI

Dustin Cupp, D.O.

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1417113226
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4632 Issued in OK
Practice address
7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone
(918) 710-4200
Fax
(918) 403-6331
NPI assigned
Jul 31, 2008
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4632 OK Primary

Addresses

Primary practice location

7501 Riverside Pkwy
Tulsa, OK 74136-5056

Mailing address

7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone (918) 710-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081125000111 OK Practitioner - Family Practice 6800956517 Reassigns benefits to 3 organizations
I20130305000481 KY Practitioner - Family Practice 6800956517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Suite 300
Owasso, OK 74055-6638
Phone (918) 376-8900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4632OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jan 13, 2015 Accepting new patients
Omni Medical Group Inc Family Medicine CurrentSince Feb 11, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC Family Medicine CurrentSince Jul 1, 2008 Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Jan 13, 2015 Accepting new patients
Apogee Medical Group Kentucky PSC CurrentSince Jun 26, 2013 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jul 1, 2008 Accepting new patients

Locations

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

316 W 2nd St
Morehead, KY 40351
Phone (606) 783-6400

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

10512 N 110th East Ave
Ste 300
Owasso, OK 74055
Phone (918) 272-1172

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

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

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

1919 S Wheeling Ave
Ste 200
Tulsa, OK 74104
Phone (918) 748-7600

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

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: dcupp1005107@ahs.direct-ci.com
  • Direct secure messaging: dustin.cuppdo.p10@direct.nextcare.nextgenshare.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1417113226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "DUSTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.