NPIMap

Individual provider Active NPI

Jesicah Marie Gilmore, M.D.

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1487970158
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27867 Issued in OK
Practice address
550 S Peoria Ave
Tulsa, OK 74120-3820
Phone
(918) 588-1900
Fax
(918) 582-6405
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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 27867 OK Primary

Addresses

Primary practice location

550 S Peoria Ave
Tulsa, OK 74120-3820

Mailing address

550 S Peoria Ave
Tulsa, OK 74120-3820
Phone (918) 588-1900

Other identifiers 7

IdentifierTypeStateIssuer
100732910-GOtherOKGROUP MEDICAID/SOONERCARE
200330420 BMedicaidOK
73-1042545OtherOKGROUP BCBS
731042545001OtherOKGROUP TRICARE
100732910-AOtherOKGROUP MEDICAID/SOONERCARE
73-1042545OtherOKGROUP COMMUNITY CARE OF OKLAHOMA
73-1042545OtherOKGROUP MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20141203000568 OK Practitioner - Family Practice 2567694193 Reassigns benefits to 1 organization
I20241017003168 TX Practitioner - Family Practice 2567694193 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics Family Medicine CurrentSince Oct 10, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Oct 10, 2024 Accepting new patients
Creek Nation Hospital & Clinics Family Medicine Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Oct 10, 2024 Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. PastSince Sep 21, 2014 Accepting new patients

Locations

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: jgilmore23250@muscogeecreeknation.direct-ci.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creek Nation Hospital and Clinics 364 clinicians

Practice addresses (Care Compare)

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

Hospital & facility affiliations

  • Elara Caring XXV Home health agency, Tulsa, OK, CCN 377667
  • Enhabit Home Health of Northeast Oklahoma Home health agency, Broken Arrow, OK, CCN 377572
  • Council Oak Comprehensive Healthcare Hospital, Tulsa, OK, CCN 370244
  • Creek Nation Community Hospital Hospital, Okemah, OK, CCN 371333

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue21
Removal or shaving of skin growth1-10
Skin biopsy1-10

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1487970158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "JESICAH",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "27867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID/SOONERCARE",
            "identifier": "100732910-G",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200330420 B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "73-1042545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TRICARE",
            "identifier": "731042545001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID/SOONERCARE",
            "identifier": "100732910-A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP COMMUNITY CARE OF OKLAHOMA",
            "identifier": "73-1042545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "73-1042545",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.