Individual provider Active NPI

Matthew A. Richardson, M.D.

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1508284563
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
38664 Issued in OK
Practice address
4444 E 41St St
Tulsa, OK 74135-2527
Phone
(918) 619-4400
Fax
(918) 660-3132
NPI assigned
Apr 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 38664 OK Primary

Addresses

Primary practice location

4444 E 41St St
Tulsa, OK 74135-2527

Mailing address

PO Box 268838
Oklahoma City, OK 73126-8838
Phone (918) 660-3511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, ID2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211129001061 OK Practitioner - Psychiatry 2365744026 Reassigns benefits to 1 organization
I20241111002921 ID Practitioner - Psychiatry 2365744026 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Health Services, LLC Current Accepting new patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Nov 15, 2021 Accepting new patients
Pocatello Health Services, LLC CurrentSince Oct 8, 2024 Accepting new patients
Pocatello Health Services, LLC CurrentSince Oct 8, 2024 Accepting new patients
Pocatello Hospital LLC Past Accepting new patients

Locations

777 Hospital Way
Fl 5
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

4502 E 41st St
Tulsa, OK 74135
Phone (918) 579-2367

4444 E 41st St
Tulsa, OK 74135

Interoperability endpoints

  • Direct secure messaging: mrichardson1136898@ahs.direct-ci.com

Organizations & group practices 5

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": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1508284563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268838",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268838",
            "telephone_number": "918-660-3511",
            "fax_number": "918-660-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352527",
            "telephone_number": "918-619-4400",
            "fax_number": "918-660-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MATTHEW",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-06",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "38664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.