NPIMap

Individual provider Active NPI

Kusum Bhandari, MD

  • Nephrology Physician
  • Tulsa, OK
National Provider Identifier
1700952884
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
23125 Issued in OK
Practice address
1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4000
Phone
(918) 712-5000
Fax
(918) 592-0286
NPI assigned
Nov 28, 2006
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 23125 OK Primary

Addresses

Primary practice location

1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4000

Mailing address

1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4000
Phone (918) 712-5000

Other identifiers 1

IdentifierTypeStateIssuer
200003220AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050218000021 OK Practitioner - NephrologyPractitioner - Internal Medicine 5193777365 Reassigns benefits to 1 organization
Practice locations: Tulsa, OK

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tni-Kso PCGroup PAC ID 2062464399, 20 clinicians

Practice addresses (Care Compare)

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7807
Phone 9187125000152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23125OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St John Medical Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kusum.bhandari@direct.davitaphysiciansolutions.com
  • Direct secure messaging: kusum.bhandari@direct.stjohnhealthsystem.com

Organizations & group practices 2

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 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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1700952884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 364",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-712-5000",
            "fax_number": "918-592-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 364",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-712-5000",
            "fax_number": "918-592-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANDARI",
        "first_name": "KUSUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "23125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200003220A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.