Active NPI
Manek Edalji Anklesaria, MD
- Ophthalmology Physician
- Tulsa, OK
National Provider Identifier
1689648958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 13574
- Practice address
- 4815 S Harvard Ave Ste 210
Tulsa, OK 74135-3066 - Phone
- (918) 895-7855
- Fax
- (918) 745-9800
- NPI assigned
- Feb 14, 2006
- Last updated
- Mar 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 13574 | OK | Primary |
Addresses
Primary practice location
4815 S Harvard Ave Ste 210
Tulsa, OK 74135-3066
Mailing address
4815 S Harvard Ave Ste 210
Tulsa, OK 74135-3066
Phone (918) 895-7855
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100249760C | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13574 | OK | MD | Ophthalmology Physician |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553644800000",
"number": "1689648958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4815 S HARVARD AVE STE 210",
"city": "TULSA",
"state": "OK",
"postal_code": "741353066",
"telephone_number": "918-895-7855",
"fax_number": "918-745-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4815 S HARVARD AVE STE 210",
"city": "TULSA",
"state": "OK",
"postal_code": "741353066",
"telephone_number": "918-895-7855",
"fax_number": "918-745-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANKLESARIA",
"first_name": "MANEK",
"middle_name": "EDALJI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2019-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OK",
"license": "13574",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100249760C",
"state": "OK"
}
],
"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 Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.