Individual provider Active NPI

Roopesh Sai Jakulla, MD

  • Cardiovascular Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1437727922
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
42835 Issued in OK
Practice address
800 Stanton L Young Blvd # 5400
Oklahoma City, OK 73104-5018
Phone
(405) 271-4742
NPI assigned
Jun 11, 2021
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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
Cardiovascular Disease Physician 207RC0000X 42835 OK Primary

Addresses

Primary practice location

800 Stanton L Young Blvd # 5400
Oklahoma City, OK 73104-5018

Mailing address

2301 Holmes Street Truman Medical Center -Hospital Hill
Kansas City, KS 64108
Phone (816) 404-4175

Other practice location 1

2301 Holmes Street Truman Medical Center -Hospital Hill
Kansas City, KS 64108
Phone (816) 404-4175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42835OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Cardiovascular Physicians LLC Cardiovascular Disease PastSince Sep 29, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1437727922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HOLMES STREET TRUMAN MEDICAL CENTER -HOSPITAL HILL",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "64108",
            "telephone_number": "816-404-4175",
            "fax_number": "816-404-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STANTON L YOUNG BLVD # 5400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045018",
            "telephone_number": "405-271-4742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes Street Truman Medical Center -Hospital Hill",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "64108",
            "country_code": "US",
            "telephone_number": "816-404-4175",
            "fax_number": "816-404-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAKULLA",
        "first_name": "ROOPESH SAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "42835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.