Individual provider Active NPI

John Marc Shellenberger, MD

  • Surgical Critical Care Physician
  • Tulsa, OK
National Provider Identifier
1548600992
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
34961 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1992
Phone
(918) 494-1805
Fax
(918) 494-4573
NPI assigned
Jun 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2013022036 MO
Surgical Critical Care Physician 2086S0102X 34961 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1992

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190822001084 OK Practitioner - General Surgery 6608000773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Arkansas College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care Communications LLCGroup PAC ID 8820136724, 33 clinicians
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6161 S Yale Ave
Tulsa, OK 74136-1902

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34961OKMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care Communications LLC CurrentSince Sep 2, 2019 Accepting new patients
Warren Clinic Inc CurrentSince Sep 2, 2019 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6600 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-1805

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: jshellenberger197652@direct.saintfrancis.com

Organizations & group practices 3

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 6

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": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1548600992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361992",
            "telephone_number": "918-494-1805",
            "fax_number": "918-494-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBERGER",
        "first_name": "JOHN MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-30",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2013022036",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OK",
            "license": "34961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.