Individual provider Active NPI

Maria Cristina Malamug Trinidad, DNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1619615523
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R0065652 Issued in OK
Practice address
1705 E 19TH St Ste 502
Tulsa, OK 74104-5416
Phone
(918) 748-7800
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R0065652 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 502
Tulsa, OK 74104-5416

Mailing address

1708 W Durham St
Broken Arrow, OK 74011-4068
Phone (918) 984-7649

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
I20220830002048 OK Practitioner - Nurse Practitioner 6608250311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

1705 E 19TH St
Tulsa, OK 74104-5410

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0065652OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Aug 21, 2022 Accepting new patients
St. John Physicians, Inc. CurrentSince Aug 21, 2022 Accepting new patients
St John Cardiovasuclar Services Inc Past Accepting new patients

Locations

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089

2000 S Wheeling Ave
Ste 100
Tulsa, OK 74104
Phone (918) 403-7070

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 502
Tulsa, OK 74104
Phone (918) 743-6675

Organizations & group practices 3

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 3

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1619615523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 W DURHAM ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740114068",
            "telephone_number": "918-984-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 502",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045416",
            "telephone_number": "918-748-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINIDAD",
        "first_name": "MARIA CRISTINA",
        "middle_name": "MALAMUG",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "R0065652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.