NPIMap

Individual provider Active NPI

Michael R Phillips, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tulsa, OK
National Provider Identifier
1619904513
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
29306 Issued in OK
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 712-3366
Fax
(918) 403-6343
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 118211 MO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 29306 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 712-3366

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
I20120913000756 OK Practitioner - Cardiac Surgery 4385540160 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
University of Missouri, Columbia School of Medicine, 1993
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

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)28
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Feb 12, 2019 Accepting new patients
St. John Physicians, Inc CurrentSince Jun 20, 2023 Accepting new patients
Ahs Oklahoma Heart LLC CurrentSince Feb 25, 2013 Accepting new patients
St. John Physicians, Inc. CurrentSince Jun 20, 2023 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 12, 2019 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Locations

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

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

Dept 1467
Tulsa, OK 74182

1265 S Utica Ave
Ste 105
Tulsa, OK 74104
Phone (918) 584-2500

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

Dept 1218
Tulsa, OK 74182

1923 S Utica Ave
#5
Tulsa, OK 74104

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

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

1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 855-2570

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1619904513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-712-3366",
            "fax_number": "918-403-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-712-3366",
            "fax_number": "918-403-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "118211",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OK",
            "license": "29306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.