Brett Michael Anderson, M.D.
Individual provider Active NPI Emergency Medicine Physician · Tulsa, OK
NPI 1497042279 · NPPES record last updated Sep 24, 2024
Key facts
- NPI
- 1497042279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 30361 (OK)
- Practice address
- 1923 S Utica Ave
Tulsa, OK 74104-6520 - Phone
- (918) 744-3528
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.51 of 100
- Quality
- 84.87
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140717001041 | OK | Practitioner - Emergency Medicine | 6002059433 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30361 | OK | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. John Physicians, Inc. | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Physicians of Tulsa County, LLC | Emergency Medicine | Current |
Accepting new patients |
| St. John Physicians, Inc | Current |
Accepting new patients | |
| St John Medical Center Inc | Past | Accepting new patients |
Locations
1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000
1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 30361 | OK | Yes |
Addresses
Primary practice location
1923 S Utica Ave
Tulsa, OK 74104-6520
Mailing address
1923 S Utica Ave
Tulsa, OK 74104-6520
Other providers in Tulsa, OK
- Andria Lenay Anderson
- Ben Anderson
- Benjamin Coleman Anderson
- Blake L Anderson
- Brenda Kay Anderson
- Brianna Anderson
- Bridget Anderson
- Brooke Anne Anderson
- Carly Anderson
- Cayla Allison Anderson
All providers in Tulsa, OK · Emergency Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.