Individual provider Active NPI

Raye Reeder, MD

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1437611498
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34948 Issued in OK
Practice address
1111 S Saint Louis Ave
Tulsa, OK 74120-5440
Phone
(918) 619-4600
Fax
(918) 649-4696
NPI assigned
Apr 1, 2019
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 34948 OK Primary

Addresses

Primary practice location

1111 S Saint Louis Ave
Tulsa, OK 74120-5440

Mailing address

1111 S Saint Louis Ave
Tulsa, OK 74120-5440
Phone (918) 619-4600

Other identifiers 1

IdentifierTypeStateIssuer
101093470AMedicaidOK

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
I20220916001912 OK Practitioner - Family Practice 2961887609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

591 E 36TH St N
Ou Physicians Tulsa Wayman Tisdale Clinic
Tulsa, OK 74106-1812
Phone (918) 619-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34948OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Aug 16, 2022 Accepting new patients

Locations

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

591 E 36th St N
Tulsa, OK 74106
Phone (918) 619-8700

Interoperability endpoints

  • Direct secure messaging: rreeder28394@ouhealth.direct-ci.net

Organizations & group practices 1

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 1

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1437611498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S SAINT LOUIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205440",
            "telephone_number": "918-619-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S SAINT LOUIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205440",
            "telephone_number": "918-619-4600",
            "fax_number": "918-649-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "RAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "34948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101093470A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.