Individual provider Active NPI

Travis James Buchanan, PA-C

  • Physician Assistant
  • Broken Arrow, OK
National Provider Identifier
1710281894
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1939 Issued in OK
Practice address
4304 W Houston St
Broken Arrow, OK 74012-4519
Phone
(872) 231-3162
Fax
(702) 977-1496
NPI assigned
Jan 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1939 OK Primary
Surgical Physician Assistant 363AS0400X 1939 OK

Addresses

Primary practice location

4304 W Houston St
Broken Arrow, OK 74012-4519

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-0595

Other identifiers 2

IdentifierTypeStateIssuer
1939OtherOKOKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION
200319100AMedicaidOK

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
I20110224000067 OK Practitioner - Physician Assistant 5395926398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehab Consultants LLCGroup PAC ID 7810184892, 162 clinicians

Practice addresses (Care Compare)

17110 E 51St St
Franciscan Villa
Broken Arrow, OK 74012-9279
Phone (918) 355-1596

3200 W Washington St
Broken Arrow, OK 74012-9044
Phone (918) 505-9995

3211 Chandler Rd
Muskogee, OK 74403-4925
Phone (312) 635-0973

3230 E Shawnee Rd
Muskogee, OK 74403-1813
Phone (312) 635-0973

4300 W Houston St
Forest Hills
Broken Arrow, OK 74012-4519
Phone (918) 254-5000

4304 W Houston St
Broken Arrow, OK 74012-4519
Phone (312) 635-0973

5701 W Britton Rd
Oklahoma City, OK 73132-2402
Phone (405) 773-8900

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
73.83
Improvement activities
40
Cost
45.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TEMPOKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehab Consultants LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

4300 W Houston St
Broken Arrow, OK 74012
Phone (918) 250-1700

3501 W Washington St
Broken Arrow, OK 74012
Phone (918) 250-0037

4304 W Houston St
Broken Arrow, OK 74012
Phone 84723561304

3200 W Washington St
Broken Arrow, OK 74012
Phone (918) 505-9995

2800 Hickory St
Claremore, OK 74017
Phone (918) 283-4948

2300 W Broadway St
Collinsville, OK 74021
Phone (918) 371-2545

212 N Antes Ave
Henryetta, OK 74437
Phone (918) 652-8792

3211 Chandler Rd
Muskogee, OK 74403
Phone (539) 399-2151

5701 W Britton Rd
Oklahoma City, OK 73132
Phone (405) 773-8900

1307 R D Miller Dr
Okmulgee, OK 74447
Phone (918) 756-5611

10098 N 123rd East Ave
Owasso, OK 74055
Phone (918) 232-0305

8720 S 101st East Ave
Tulsa, OK 74133
Phone (918) 965-0101

10912 E 14th St
Tulsa, OK 74128
Phone (918) 438-2440

5721 S Lewis Ave
Tulsa, OK 74105
Phone (918) 447-6447

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1710281894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008272",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748272",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124519",
            "telephone_number": "872-231-3162",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "TRAVIS",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-04",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1939",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION",
            "identifier": "1939",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200319100A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.