Individual provider Active NPI

Rodney Clingan, M.D.

  • Colon & Rectal Surgery Physician
  • Tulsa, OK
National Provider Identifier
1669433421
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
21220 Issued in OK
Practice address
1705 E 19TH St Ste 502
Tulsa, OK 74104-5416
Phone
(918) 748-7800
Fax
(918) 748-7801
NPI assigned
Mar 31, 2006
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 21220 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 502
Tulsa, OK 74104-5416

Mailing address

1705 E 19TH St Ste 502
Tulsa, OK 74104-5416
Phone (918) 748-7800

Other identifiers 1

IdentifierTypeStateIssuer
100164660BMedicaidOK

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
I20040825000970 OK Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 2062486939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Texas Tech University Health Science Center School of Medicine, 1998
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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy118
Melanoma (skin cancer) excision1-10
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21220OKMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 25, 2005 Accepting new patients
St. John Physicians, Inc. Colon & Rectal Surgery CurrentSince Jul 25, 2005 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Colon & Rectal Clinic of Tulsa PC Colon & Rectal Surgery Past Accepting new patients
Midtown Dermatology LLC PastSince Oct 4, 2020 Accepting new patients
Center for Cardiovascular Medicine Past Accepting new patients

Locations

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

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

1705 E 19th St
Ste 705
Tulsa, OK 74104
Phone (918) 744-7887

Organizations & group practices 6

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 3

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1669433421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 502",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045416",
            "telephone_number": "918-748-7800",
            "fax_number": "918-748-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 502",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045416",
            "telephone_number": "918-748-7800",
            "fax_number": "918-748-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINGAN",
        "first_name": "RODNEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "OK",
            "license": "21220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100164660B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.