Individual provider Active NPI

Clinton D Cator, PA

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1609117498
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2255 Issued in OK
Practice address
1809 E 13TH St Ste 402
Tulsa, OK 74104
Phone
(918) 579-2300
Fax
(918) 579-2309
NPI assigned
Mar 5, 2013
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2255 OK Primary

Addresses

Primary practice location

1809 E 13TH St Ste 402
Tulsa, OK 74104

Mailing address

1809 E 13TH St Ste 402
Tulsa, OK 74104-4431
Phone (918) 579-2300

Other identifiers 1

IdentifierTypeStateIssuer
200484090AMedicaidOK

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
I20130826000816 OK Practitioner - Physician Assistant 3678716438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-9393

1809 E 13TH St
Tulsa, OK 74104-4431

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

615 S 32ND St
Muskogee, OK 74401-5012
Phone (593) 239-5240

6901 S Olympia Ave
Tulsa, OK 74132-1843
Phone (918) 388-5701

8801 S 101St E Ave
Tulsa, OK 74133-5716
Phone (918) 294-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2255OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Physician Assistant CurrentSince May 13, 2017 Accepting new patients

Locations

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1809 E 13th St
Ste 402
Tulsa, OK 74104
Phone (918) 579-2300

9001 S 101st East Ave
Ste 190
Tulsa, OK 74133
Phone (918) 392-9670

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: ccator112731@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 1

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 4

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": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1609117498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 E 13TH ST STE 402",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044431",
            "telephone_number": "918-579-2300",
            "fax_number": "918-579-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 E 13TH ST STE 402",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-579-2300",
            "fax_number": "918-579-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATOR",
        "first_name": "CLINTON",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200484090A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.