NPIMap

Individual provider Active NPI

Maria Elizabeth Super, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1619310422
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5635 Issued in OK
Practice address
2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647
Phone
(918) 403-7801
Fax
(918) 403-6437
NPI assigned
Apr 10, 2013
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5635 OK Primary

Addresses

Primary practice location

2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647

Mailing address

2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647
Phone (918) 403-7801

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
I20160609000993 OK Practitioner - Internal Medicine 3476843095 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians
Usacs Observation Medicine Services of Oklahoma, LLCGroup PAC ID 9931562956, 203 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Suite 302
Tulsa, OK 74104-5410
Phone (918) 748-7599

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-3131

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.31 of 100Reported as group
Improvement activities
20
Cost
82.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5635OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 11, 2016 Accepting new patients
Tulsa Hospital Medicine Physicians Group, LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Nov 5, 2024 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Jul 11, 2016 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Nov 22, 2021 Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

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

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

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: maria.super@direct.stjohnhealthsystem.com

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 8

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1619310422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 701",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045647",
            "telephone_number": "918-403-7801",
            "fax_number": "918-403-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 701",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045647",
            "telephone_number": "918-403-7801",
            "fax_number": "918-403-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPER",
        "first_name": "MARIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.