Individual provider Active NPI

Kale Scott Goerke, D.O.

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1447790092
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
6407 Issued in OK
Practice address
744 W 9TH St
Tulsa, OK 74127-9020
Phone
(580) 791-1027
NPI assigned
Mar 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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
Anesthesiology Physician 207L00000X 6407 OK Primary

Addresses

Primary practice location

744 W 9TH St
Tulsa, OK 74127-9020

Mailing address

1128 NW 56TH St
Oklahoma City, OK 73118-1222
Phone (580) 791-1027

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
I20210524002075 OK Practitioner - Anesthesiology 9931508900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Professionals, PLLC Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

3300 NW Expressway St
Fl 2
Oklahoma City, OK 73112
Phone (405) 251-2815

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

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 and National Provider Directory roles.

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1447790092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 NW 56TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181222",
            "telephone_number": "580-791-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "580-791-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERKE",
        "first_name": "KALE",
        "middle_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "6407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.