Individual provider Active NPI

Gajalakshmi Kumar, MD

  • Trauma Surgery Physician
  • Tulsa, OK
National Provider Identifier
1578836201
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
30604 Issued in OK
Practice address
1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5638
Phone
(918) 301-2505
Fax
(918) 744-3633
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 30604 OK
Trauma Surgery Physician 2086S0127X 30604 OK Primary

Addresses

Primary practice location

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5638

Mailing address

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5638
Phone (918) 301-2505

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
I20140827000360 OK Practitioner - General Surgery 3577781970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2008
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)

1919 S Wheeling Ave
Suite 606
Tulsa, OK 74104-5635
Phone (918) 748-7676

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312
  • Labette Health Hospital, Parsons, KS, CCN 170120
  • St John Owasso Hospital, Owasso, OK, CCN 370227

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Aug 26, 2014 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

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

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

1919 S Wheeling Ave
Ste 600
Tulsa, OK 74104
Phone (918) 634-7500

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104
Phone (918) 748-7676

Interoperability endpoints

  • Direct secure messaging: gajal.kumar@direct.stjohnhealthsystem.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 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": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1578836201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-301-2505",
            "fax_number": "918-744-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-301-2505",
            "fax_number": "918-744-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "GAJALAKSHMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "30604",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "OK",
            "license": "30604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.