Individual provider Active NPI

Jose Ivan Vela-Hernandez, D.O.

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1528107406
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4375 Issued in OK
Practice address
HHS Centralized Verification/Medical Staff Services
1120 S Utica Ave
Tulsa, OK 74104
Phone
(918) 579-2528
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-4412 AR
Anesthesiology Physician 207L00000X 4375 OK Primary

Addresses

Primary practice location

HHS Centralized Verification/Medical Staff Services
1120 S Utica Ave
Tulsa, OK 74104

Mailing address

10501 Castleton St
Fort Smith, AR 72908-9394
Phone (918) 344-6952

Other practice location 1

8801 South 101st East Avenue
SouthCrest Anesthesia Group
Tulsa, OK 74133
Phone (918) 294-4915

Other identifiers 2

IdentifierTypeStateIssuer
900522349OtherOKMEDICARE GROUP PIN
200075040AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20070711000921 OK Practitioner - Anesthesiology 1850326661 Reassigns benefits to 3 organizations
I20220519002556 TX Practitioner - Anesthesiology 1850326661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Integral Anesthesia LLCGroup PAC ID 9638461973, 159 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

3029 W Main St
Jenks, OK 74037-3465
Phone (918) 701-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4375OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Oklahoma, PLLC Anesthesiology CurrentSince Jun 29, 2023 Accepting new patients
Emergenchealth PLLC Anesthesiology CurrentSince May 1, 2020 Accepting new patients
River Valley Anesthesia Associates, P. a. Anesthesiology Past Accepting new patients
Ahs Oklahoma Physician Group LLC Past Accepting new patients
Southcrest Anesthesia Group LLC Anesthesiology Past Accepting new patients

Locations

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

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

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 6

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 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1528107406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 CASTLETON ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729089394",
            "telephone_number": "918-344-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HHS CENTRALIZED VERIFICATION/MEDICAL STAFF SERVICES",
            "address_2": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-579-2528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8801 South 101st East Avenue",
            "address_2": "SouthCrest Anesthesia Group",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74133",
            "country_code": "US",
            "telephone_number": "918-294-4915",
            "fax_number": "918-294-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELA-HERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-4412",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "4375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "900522349",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075040A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.