NPIMap

Individual provider Active NPI

Timothy Vavricka, MD

  • Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1700927175
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
24483 Issued in OK
Practice address
401 SW 80TH St Ste 101
Oklahoma City, OK 73139
Phone
(405) 601-5169
Fax
(405) 601-9095
NPI assigned
Feb 9, 2007
Last updated
Jun 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 24483 OK Primary

Addresses

Primary practice location

401 SW 80TH St Ste 101
Oklahoma City, OK 73139

Mailing address

401 SW 80TH St Ste 101
Oklahoma City, OK 73139-8123
Phone (405) 601-5169

Other practice location 1

920 Stanton L Young Blvd
WP 2140
Oklahoma City, OK 73104-5020
Phone (405) 271-6308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20141013001711 OK Practitioner - General Surgery 8325268477 Reassigns benefits to 4 organizations
I20240715000497 TX Practitioner - General Surgery 8325268477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newman Memorial Hospital, IncGroup PAC ID 2567482367, shared by 3 NPIs, 29 clinicians

Practice addresses (Care Compare)

1000 15TH St
Woodward, OK 73801-3008
Phone (580) 571-3160

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

2525 NW Expressway
Suite 610
Oklahoma City, OK 73112-7251
Phone (405) 286-9465

905 S Main
Shattuck, OK 73858-9205

905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24483OKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Surgical Group, PLLC Surgery CurrentSince Jul 1, 2016 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 1, 2016 Accepting new patients
Chickasaw Nation Division of Health Current Accepting new patients
Newman Memorial Hospital, Inc CurrentSince Mar 2, 2026 Accepting new patients
Chickasaw Nation Division of Health CurrentSince Jun 21, 2024 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 1, 2016 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Jun 21, 2024 Accepting new patients
Oklahoma Center for Orthopaedic & Multi-Specialty Surgery, LLC Past Accepting new patients
Newman Memorial Hospital, Inc. Past Accepting new patients
Newman Memorial Hospital, Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
Chickasaw Nation Division of Health Past Accepting new patients
Newman Memorial Hospital, Inc Past Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

2525 NW Expressway
Ste 610
Oklahoma City, OK 73112
Phone (405) 242-2181

401 SW 80th St
Ste 101
Oklahoma City, OK 73139
Phone (405) 601-4227

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

920 Stanton L Young Blvd
#2140
Oklahoma City, OK 73104
Phone (405) 271-6308

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

1000 15th St
Woodward, OK 73801
Phone (580) 256-2820

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ed29dd2e-7f6b-4b48-93ba-6ba78c79cd2d/
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEAHBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEAHBA/Endpoint/EEAHBA
  • Direct secure messaging: tvavricka28568@direct.chickasawnationhealth.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 11

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1700927175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SW 80TH ST STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398123",
            "telephone_number": "405-601-5169",
            "fax_number": "405-601-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SW 80TH ST STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73139",
            "telephone_number": "405-601-5169",
            "fax_number": "405-601-9095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Stanton L Young Blvd",
            "address_2": "WP 2140",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045020",
            "country_code": "US",
            "telephone_number": "405-271-6308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAVRICKA",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "24483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.