Individual provider Active NPI

Stephanie Moore, CNS

  • Clinical Nurse Specialist
  • Tulsa, OK
National Provider Identifier
1578834396
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
R0065008 Issued in OK
Practice address
6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806
Phone
(918) 582-3154
NPI assigned
Jan 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R0065008 OK Primary

Addresses

Primary practice location

6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806

Mailing address

6465 S Yale Ave Ste 401
Tulsa, OK 74136-7806
Phone (918) 582-3154

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120608000423 OK Practitioner - Certified Clinical Nurse Specialist (CNS) 3678737376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osteopathic Physicians of Tulsa, Inc.Group PAC ID 1850383662, 8 clinicians

Practice addresses (Care Compare)

215 S Brady St
Claremore, OK 74017-5005
Phone (918) 582-3154

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.8 of 100Reported as group
Quality
81.62
Promoting interoperability
99
Improvement activities
40
Cost
72.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0065008OKMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Physicians of Tulsa, Inc. CurrentSince Apr 12, 2021 Accepting new patients
Nephrology Associates, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Osteopathic Physicians of Tulsa, Inc Past Accepting new patients

Locations

3500 State St
Bartlesville, OK 74006
Phone (918) 224-9620

215 S Brady St
Claremore, OK 74017
Phone (918) 283-2946

802 S Jackson Ave
Ste 301
Tulsa, OK 74127
Phone (918) 582-3154

Dept 2761
Tulsa, OK 74182
Phone (918) 582-3154

6465 S Yale Ave
Ste 401
Tulsa, OK 74136
Phone (918) 561-6141

2000 S Wheeling Ave
Ste 510
Tulsa, OK 74104
Phone (918) 747-5200

Dept 515
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: stephanie.moore@direct.davitaphysiciansolutions.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": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1578834396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-582-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-582-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OK",
            "license": "R0065008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.