NPIMap

Individual provider Active NPI

Matthew Haney, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1548614282
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6181 Issued in OK
Practice address
7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone
(918) 710-4200
Fax
(918) 403-6331
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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 6181 OK
Family Medicine Physician 207Q00000X 6181 OK Primary

Addresses

Primary practice location

7501 Riverside Pkwy
Tulsa, OK 74136-5056

Mailing address

7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone (918) 710-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171020001849 OK Practitioner - Family Practice 9638445554 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6181OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Family Medicine CurrentSince Feb 1, 2022 Accepting new patients
Williams Medical Group Practice, LLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
St. John Physicians, Inc CurrentSince Nov 1, 2017 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Aug 1, 2020 Accepting new patients
St John Urgent Care Clinics Inc Past Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

2525 Chandler Rd
Muskogee, OK 74403
Phone (918) 232-0768

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

949 E Taft Ave
Sapulpa, OK 74066
Phone (918) 224-6079

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

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

7501 Riverside Pkwy
Tulsa, OK 74136
Phone (918) 710-4200

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

Organizations & group practices 8

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 7

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1548614282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365056",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "6181",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.