Individual provider Active NPI

Jessica Rey Childe, D.O.

  • Orthopaedic Hand Surgery Physician
  • Tulsa, OK
National Provider Identifier
1568784957
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
5910 Issued in OK
Practice address
4802 S 109TH East Ave
Tulsa, OK 74146-5822
Phone
(918) 392-1400
Fax
(918) 392-1488
NPI assigned
Feb 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 5910 OK Primary

Addresses

Primary practice location

4802 S 109TH East Ave
Tulsa, OK 74146-5822

Mailing address

4802 S 109TH East Ave
Tulsa, OK 74146-5822
Phone (918) 392-1400

Other identifiers 1

IdentifierTypeStateIssuer
200649470AMedicaidOK

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
I20160808001483 OK Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 1951695329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
61.03
Promoting interoperability
99
Improvement activities
40
Cost
77.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)86
Removal of tissue16
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5910OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Bone & Joint Associates PC Hand Surgery CurrentSince Sep 1, 2016 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Osu Health System Anesthesia Past Accepting new patients

Locations

4802 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

4800 S 109th East Ave
Tulsa, OK 74146
Phone (918) 742-2502

4808 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

Interoperability endpoints

  • Direct secure messaging: jessica.childe@tbja.gwaydirect.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1601
  • Direct secure messaging: jchilde268949@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 2

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": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1568784957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDE",
        "first_name": "JESSICA",
        "middle_name": "REY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OK",
            "license": "5910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200649470A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.