NPIMap

Individual provider Active NPI

Wesley Todd Brookover, MD

  • Urology Physician
  • Tulsa, OK
National Provider Identifier
1659457455
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
18009 Issued in OK
Practice address
10901 E 48TH St
Tulsa, OK 74146-5830
Phone
(918) 749-8765
Fax
(918) 392-2155
NPI assigned
Oct 27, 2006
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 18009 OK Primary

Addresses

Primary practice location

10901 E 48TH St
Tulsa, OK 74146-5830

Mailing address

10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765

Other identifiers 1

IdentifierTypeStateIssuer
100124930BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR, MO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20041124000116 OK Practitioner - Urology 0042288672 Reassigns benefits to 1 organization
I20140609000665 AR Practitioner - Urology 0042288672 Reassigns benefits to 1 organization
I20140814002760 MO Practitioner - Urology 0042288672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Oklahoma College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765

6801 Rogers Ave
Suite 202
Fort Smith, AR 72903-4067
Phone (918) 749-8765

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18009OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince May 15, 2016 Accepting new patients
Breast Health Specialists of Oklahoma PLLC Past Accepting new patients
Oklahoma Surgical Hospital, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 530
Joplin, MO 64804
Phone (417) 556-3828

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/37d0fa6b-e0f7-4581-adbb-f9e2eac855e1/
  • Direct secure messaging: wesleybrookover@usoinc.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oklahoma Surgical Hospital LLCTulsa, OK, CCN 370210 Hospital General Partnership Interest (1.2%) Aug 11, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 7

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1659457455",
    "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": "10901 E 48TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465830",
            "telephone_number": "918-749-8765",
            "fax_number": "918-392-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKOVER",
        "first_name": "WESLEY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "18009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124930B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.