Individual provider Active NPI

Eric Gregory, PA

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1497046437
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1966 Issued in OK
Practice address
2000 S Wheeling Ave
Tulsa, OK 74104-5649
Phone
(918) 748-7854
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1966 OK Primary

Addresses

Primary practice location

2000 S Wheeling Ave
Tulsa, OK 74104-5649

Mailing address

2000 S Wheeling Ave
Tulsa, OK 74104-5649
Phone (918) 748-7854

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000426 OK Practitioner - Physician Assistant 8921272196 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St John Urgent Care Clinics IncGroup PAC ID 5890898084, 29 clinicians

Practice addresses (Care Compare)

1717 S Utica Ave
Suite a
Tulsa, OK 74104-5346
Phone (918) 748-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1966OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Sep 20, 2011 Accepting new patients
St. John Physicians, Inc. Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients
Mission Treatment Centers, Inc. Past Accepting new patients
Mission Treatment Centers, Inc. Past Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1497046437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045649",
            "telephone_number": "918-748-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045649",
            "telephone_number": "918-748-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.