Individual provider Active NPI

Robert Devadhas, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1588925580
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R104024 Issued in OK
Practice address
1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone
(918) 744-3664
Fax
(918) 748-7688
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R104024 OK Primary

Addresses

Primary practice location

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909

Mailing address

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone (918) 744-3664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000269 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355599895 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Integral Anesthesia LLCGroup PAC ID 9638461973, 159 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Bailey Med Ctr
Owasso, OK 74055-6636
Phone (918) 376-8000

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (919) 744-3131

3029 W Main St
Jenks, OK 74037-3465
Phone (918) 701-2300

3500 E Frank Phillips Blvd
Bartlesville, OK 74006-2411
Phone (918) 333-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R104024OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Oklahoma Anesthesia Consultants PLLC CurrentSince Jul 1, 2022 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC CurrentSince Sep 21, 2023 Accepting new patients
Integral Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

3029 W Main St
Jenks, OK 74037
Phone (918) 346-5002

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1588925580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE",
            "address_2": "STE 217",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE",
            "address_2": "STE 217",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVADHAS",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R104024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.