NPIMap

Individual provider Active NPI

Gregory L Wilson, D.O.

  • Neurological Surgery Physician
  • Tulsa, OK
National Provider Identifier
1619030996
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2754 Issued in OK
Practice address
9709 E 79TH St
Tulsa, OK 74133-4566
Phone
(918) 994-4000
Fax
(918) 994-4090
NPI assigned
Dec 18, 2006
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2754 OK
Neurological Surgery Physician 207T00000X 2754 OK Primary

Addresses

Primary practice location

9709 E 79TH St
Tulsa, OK 74133-4566

Mailing address

9709 E 79TH St
Tulsa, OK 74133-4566
Phone (918) 994-4000

Other identifiers 1

IdentifierTypeStateIssuer
100125210AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001045 OK Practitioner - Neurosurgery 8426095167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Oklahoma State University College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Invictus Healthcare System PLLCGroup PAC ID 2264755925, 4 clinicians

Practice addresses (Care Compare)

9709 E 79TH St
Tulsa, OK 74133-4566
Phone (918) 994-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.44 of 100Reported as individual
Quality
63.82
Improvement activities
40
Cost
83.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion11
Laminectomy or laminotomy (partial removal of spine bones)157
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Invictus Healthcare System, PLLC Neurological Surgery CurrentSince Dec 1, 2014 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

9709 E 79th St
Tulsa, OK 74133
Phone (918) 994-4000

Interoperability endpoints

  • Direct secure messaging: gregory.wilson@invictus.directbygreenway.com
  • Direct secure messaging: gwilson112831@ahs.direct-ci.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73165

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oklahoma Surgical Hospital LLCTulsa, OK, CCN 370210 Hospital General Partnership Interest (0.97%) Jan 5, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1619030996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4000",
            "fax_number": "918-994-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4000",
            "fax_number": "918-994-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GREGORY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OK",
            "license": "2754",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "2754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100125210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.