Individual provider Active NPI

Brandon J Koenigsknecht, MD

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1497218242
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34877 Issued in OK
Practice address
1145 S Utica Ave Ste 600
Tulsa, OK 74104-4070
Phone
(918) 579-1000
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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
Emergency Medicine Physician 207P00000X 34877 OK Primary

Addresses

Primary practice location

1145 S Utica Ave Ste 600
Tulsa, OK 74104-4070

Mailing address

1145 S Utica Ave Ste 600
Tulsa, OK 74104-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX, KS3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210903000524 OK Practitioner - Emergency Medicine 5395141063 Reassigns benefits to 4 organizations
I20210917001643 TX Practitioner - Emergency Medicine 5395141063 Reassigns benefits to 1 organization
I20220303000218 KS Practitioner - Emergency Medicine 5395141063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Colorado School of Medicine, Denver, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Country Emergency Physicians Group of Tulsa, PLLCGroup PAC ID 0345247052, 107 clinicians

Practice addresses (Care Compare)

1202 N Muskogee PL
Claremore, OK 74017-3058
Phone (918) 341-2556

1400 W 4TH St
Coffeyville Medical Center Emerg Dept
Coffeyville, KS 67337-3306
Phone (620) 251-1200

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

Merit-based Incentive Payment System (MIPS)

Final score
95.83 of 100Reported as group
Quality
81.24
Promoting interoperability
100
Improvement activities
40

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

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34877OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Apr 19, 2023 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jun 1, 2021 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC Emergency Medicine CurrentSince Dec 12, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jun 11, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jun 1, 2021 Accepting new patients
Ies ER Oklahoma LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

1400 W 4th St
Coffeyville, KS 67337
Phone (620) 251-1200

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

Dept 1467
Tulsa, OK 74182

Dept 1038
Tulsa, OK 74182

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

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

Organizations & group practices 9

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 3

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1497218242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 600",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 600",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044070",
            "telephone_number": "918-579-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSKNECHT",
        "first_name": "BRANDON",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "34877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.