Individual provider Active NPI

Angela Michelle Mariani, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1699298521
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
98833 Issued in OK
Practice address
8806 S Yale Ave Ste B
Tulsa, OK 74137-3712
Phone
(918) 710-2062
Fax
(918) 710-4421
NPI assigned
Jul 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 98833 OK Primary

Addresses

Primary practice location

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

Mailing address

3355 W 103Rd St N
Sperry, OK 74073-4131

Other identifiers 1

IdentifierTypeStateIssuer
20074454OAMedicaidOK

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180116002026 OK Practitioner - Nurse Practitioner 5092074203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MPP Infusion Center of Tulsa, LLCGroup PAC ID 8628476330, 5 clinicians

Practice addresses (Care Compare)

8806 S Yale Ave
Suite B
Tulsa, OK 74137-3712
Phone (918) 710-2062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MPP Infusion Center of Tulsa, LLC CurrentSince Dec 5, 2023 Accepting new patients

Locations

1726 Cole Blvd
Ste 250
Lakewood, CO 80401
Phone (303) 384-4064

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1699298521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 W 103RD ST N",
            "city": "SPERRY",
            "state": "OK",
            "postal_code": "740734131"
        },
        {
            "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",
            "fax_number": "918-710-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANI",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2024-09-03",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "98833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20074454OA",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.