NPIMap

Individual provider Active NPI

Mary Ann Cameron, MD

  • Nephrology Physician
  • Tulsa, OK
National Provider Identifier
1619924677
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
26208 Issued in OK
Practice address
6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823
Phone
(918) 481-2760
Fax
(918) 481-2775
NPI assigned
May 27, 2006
Last updated
Feb 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 26208 OK Primary

Addresses

Primary practice location

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823

Mailing address

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823
Phone (918) 481-2760

Other identifiers 1

IdentifierTypeStateIssuer
200058420AMedicaidOK

Other names 1

  • Mary Ann Gaska Former name

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
I20081031000222 OK Practitioner - Nephrology 5597769091 Reassigns benefits to 1 organization
Practice locations: Tulsa, OK

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Baylor College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tni-Kso PCGroup PAC ID 2062464399, 20 clinicians

Practice addresses (Care Compare)

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7807
Phone 9187125000152

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mary.cameron@direct.davitaphysiciansolutions.com
  • Direct secure messaging: maryann.cameron@direct.stjohnhealthsystem.com

Organizations & group practices 1

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 12

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1619924677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 507",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-481-2760",
            "fax_number": "918-481-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 507",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-481-2760",
            "fax_number": "918-481-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "26208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200058420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GASKA",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.