Active NPI
Urologic Specialists of Oklahoma Inc
- Urology Physician
- Owasso, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- UROLOGIC SPECIALISTS OF OKLAHOMA INC
- Practice address
- 12455 E 100TH St N Ste 280
Owasso, OK 74055-4675 - Phone
- (918) 505-2634
- Fax
- (918) 248-0134
- NPI assigned
- Jan 21, 2025
- Last updated
- Oct 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shaun Gobind Singh Grewal
- Title
- Authorized Official
- Phone
- (918) 749-8765
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
12455 E 100TH St N Ste 280
Owasso, OK 74055-4675
Mailing address
10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765
Other names 1
- Urologic Specialists Owasso
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250228000899 | OK | DME Supplier - Physician - Urology | 3779470091 | Practice locations: Owasso, OK |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Urologic Specialists of Arkansas, P.A.
- Urology Physician
- Fort Smith, AR
- NPI 1831944487
3779470091
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2325737 | Urologic Specialists of Oklahoma-Owasso | Provider-performed microscopy | Jun 18, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Urologic Specialists of Arkansas PA
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Tulsa, OK
- NPI 1669700571
-
dba Urologic Specialists of Arkansas, P.A.
- Urology Physician
- Fort Smith, AR
- NPI 1831944487
Locations
12455 E 100th St N
Ste 300
Owasso, OK 74055
Phone (918) 274-9700
12455 E 100th St N
Ste 380
Owasso, OK 74055
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Urology Physician
- Tulsa, OK
- NPI 1972764496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759708800000",
"number": "1619789310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 E 48TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741465830",
"telephone_number": "918-749-8765",
"fax_number": "918-392-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12455 E 100TH ST N STE 280",
"city": "OWASSO",
"state": "OK",
"postal_code": "740554675",
"telephone_number": "918-505-2634",
"fax_number": "918-248-0134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGIC SPECIALISTS OF OKLAHOMA INC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-21",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A",
"authorized_official_last_name": "GREWAL",
"authorized_official_first_name": "SHAUN",
"authorized_official_middle_name": "GOBIND SINGH",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "918-749-8765"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Urologic Specialists Owasso",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.