Individual provider Active NPI

Nicholas Ryan Peluso, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1649611898
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5927 Issued in OK
Practice address
1705 E 19TH St Ste 302
Tulsa, OK 74104-5410
Phone
(918) 748-7585
NPI assigned
Jul 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X UO3637 FL
Internal Medicine Physician 207R00000X 5927 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 302
Tulsa, OK 74104-5410

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 403-7054

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160615000574 OK Practitioner - Internal Medicine 6103117510 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Observation Medicine Services of Oklahoma, LLCGroup PAC ID 9931562956, 203 clinicians

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-3131

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO3637FLMDInternal Medicine Physician
5927OKMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Critical Care Medicine of Oklahoma, LLC CurrentSince Nov 5, 2024 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 11, 2016 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Nov 22, 2021 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Oct 14, 2024 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Jul 11, 2016 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Nov 25, 2021 Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

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

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

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

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

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 5

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": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1649611898",
    "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": "918-403-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045410",
            "telephone_number": "918-748-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELUSO",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-16",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO3637",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.