Individual provider Active NPI

Kaylee Calles, DO

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1417534728
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
7646 Issued in OK
Practice address
12020 E 31St St
Tulsa, OK 74146-2001
Phone
(918) 622-0641
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 7646 OK Primary

Addresses

Primary practice location

12020 E 31St St
Tulsa, OK 74146-2001

Mailing address

12020 E 31St St
Tulsa, OK 74146-2001
Phone (918) 622-0641

Other practice location 1

2321 E 3rd St
Tulsa, OK 74104-1831
Phone (918) 622-0641

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
I20240829000031 OK Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8729527171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7646OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Hospital, Inc. Past Accepting new patients
Community Health Connection Inc Past 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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1417534728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741462001",
            "telephone_number": "918-622-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741462001",
            "telephone_number": "918-622-0641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2321 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741041831",
            "country_code": "US",
            "telephone_number": "918-622-0641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLES",
        "first_name": "KAYLEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "7646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.