Individual provider Active NPI

Gaurav Kumar, M.D

  • Cardiovascular Disease Physician
  • Tulsa, OK
National Provider Identifier
1598796369
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25195 Issued in OK
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 748-7650
Fax
(918) 403-6341
NPI assigned
Jul 6, 2006
Last updated
Mar 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25195 OK
Cardiovascular Disease Physician 207RC0000X 25195 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 748-7650

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060727000039 OK Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5597778415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 1993
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)

1000 W Boise Circle
Emergency Room
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

1705 E 19TH St
Tulsa, OK 74104-5410

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting63
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Apr 1, 2011 Accepting new patients
St. John Physicians, Inc. Cardiovascular Disease CurrentSince Apr 1, 2011 Accepting new patients
Stillwater Medical Center Authority CurrentSince Jan 1, 2008 Accepting new patients
Stillwater Medical Center Authority Cardiovascular Disease CurrentSince Jan 1, 2008 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Cardiovascular Surgical Specialists Corp Specialist Past Accepting new patients
Soaak Clinics LLC PastSince Jul 21, 2024 Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

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 500
Tulsa, OK 74104
Phone (918) 293-6200

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

1923 S Utica Ave
Fl 4
Tulsa, OK 74104
Phone (918) 748-7650

Organizations & group practices 7

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 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1598796369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7650",
            "fax_number": "918-403-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7650",
            "fax_number": "918-403-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "GAURAV",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "25195",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "25195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.