NPIMap

Organization Active NPI

MPP Infusion Center of Tulsa, LLC

  • Infusion Therapy Clinic/Center
  • Tulsa, OK
National Provider Identifier
1639709546
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
MPP INFUSION CENTER OF TULSA, LLC
Practice address
8806 S Yale Ave Ste B
Tulsa, OK 74137-3712
Phone
(918) 710-2062
NPI assigned
Jan 20, 2020
Last updated
Apr 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Authorized official

Name
Sue Ellen Rottura
Title
Chief Operating Officer
Phone
(561) 323-8987

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

8806 S Yale Ave Ste B
Tulsa, OK 74137-3712

Mailing address

1726 Cole Blvd Ste 250
Lakewood, CO 80401-3262
Phone (720) 465-5030

Other practice location 1

7307 S Yale Ave Ste 101
Tulsa, OK 74136-7134
Phone (720) 465-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211011002857 OK Part B Supplier - Clinic/Group Practice 8628476330 Receives reassigned benefits from 6 practitioners
Practice locations: Tulsa, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2238225MPP Infusion Center of Tulsa, LLC8806 S Yale Blvd, Ste B, Tulsa, OK 74137Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

7307 S Yale Ave
#200
Tulsa, OK 74136

8806 S Yale Ave
Ste B
Tulsa, OK 74137
Phone (918) 710-2062

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1639709546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 COLE BLVD STE 250",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013262",
            "telephone_number": "720-465-5030",
            "fax_number": "720-465-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8806 S YALE AVE STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373712",
            "telephone_number": "918-710-2062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7307 S Yale Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741367134",
            "country_code": "US",
            "telephone_number": "720-465-5030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MPP INFUSION CENTER OF TULSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "ROTTURA",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-323-8987"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.

Verify at the official NPI Registry.