Individual provider Active NPI

Philip Tolentino, DO

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1710564950
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
7672 Issued in OK
Practice address
1705 E 19TH St Ste 600
Tulsa, OK 74104-5417
Phone
(918) 382-4600
Fax
(918) 382-3183
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 7672 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 600
Tulsa, OK 74104-5417

Mailing address

5310 E 31St St Ste 13
Tulsa, OK 74135-5013
Phone (918) 561-5701

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808002833 OK Practitioner - Pediatric Medicine 4082151907 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7672OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University Pediatrics CurrentSince Jun 28, 2024 Accepting new patients
Oklahoma State University CurrentSince Jun 28, 2024 Accepting new patients
Oklahoma State University Single Specialty Current Accepting new patients
State of Oklahoma Past Accepting new patients
Oklahoma State University Medical Trust Single Specialty Past Accepting new patients

Locations

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

Dept 2563
Tulsa, OK 74182

1705 E 19th St
Ste 600
Tulsa, OK 74104
Phone (918) 742-8847

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

717 S Houston Ave
Ste 400
Tulsa, OK 74127
Phone (918) 382-4600

Interoperability endpoints

  • Direct secure messaging: ptolentino206492@direct.saintfrancis.com

Organizations & group practices 5

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1710564950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355013",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 600",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045417",
            "telephone_number": "918-382-4600",
            "fax_number": "918-382-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "PHILIP",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "7672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.